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Catatonia associated with seronegative autoimmune encephalitis: a case report
Lily Rajbhandari1, Prakriti Adhikari1, Anil Nepali2
1Department of Neurology, Kanti Children Hospital, Maharajgunj, Kathmandu, Nepal.
Annals of Medicine and Surgery (2012)
|September 3, 2025
Summary
Seronegative autoimmune encephalitis can present without detectable antibodies, posing diagnostic challenges. Early immunotherapy is vital for favorable outcomes in pediatric patients with suspected autoimmune encephalitis.
Area of Science:
- Neurology
- Immunology
- Pediatrics
Background:
- Seronegative autoimmune encephalitis lacks identifiable autoantibodies in serum or cerebrospinal fluid (CSF).
- Autoimmune encephalitis (AE) diagnosis in pediatric patients presents unique challenges due to atypical presentations and absent biomarkers.
Observation:
- A 14-year-old girl with no prior medical history developed catatonia and altered mental status.
- The patient was diagnosed with seronegative autoimmune encephalitis.
Findings:
- The patient demonstrated significant improvement following treatment with immunomodulators (methylprednisolone) and lorazepam.
- Absence of detectable antibodies does not rule out autoimmune encephalitis if clinical and EEG findings are supportive.
Implications:
- Autoimmune encephalitis should be suspected in pediatric cases with rapid-onset psychological symptoms.
- Prompt and aggressive immunotherapy is crucial for achieving favorable outcomes in suspected autoimmune encephalitis.
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