Autoimmune Encephalitis in Children: From Suspicion to Diagnosis

Hon, Kam Lun; Leung, Alexander K. C; Au, Cheuk Chung; Torres, Alcy

doi:10.7759/cureus.13307

Cited by 6 publications

(9 citation statements)

References 37 publications

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“…However, limited to the understanding of diagnosis and treatment level at that time, some patients are inevitably misdiagnosed and mistreated. In this regard, the updates in diagnostic methods will help to further confirm the accurate diagnosis of patients at an early stage, make more targeted treatment in time and improve the prognosis 13 . (vi) Central nervous immune system disease tends to have longer hospitalization times and higher costs.…”

Section: Discussionmentioning

confidence: 99%

The retrospective data analysis on the pedigree of nervous system diseases in children

Liu

Chen

et al. 2023

Sci Rep

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Nowadays, the development of diagnosis and treatment technology is constantly changing the pedigree and classification of nervous system diseases. Analyzing changes in earlier disease pedigrees can help us understand the changes involved in disease diagnosis from a macro perspective, as well as predict changes in later disease pedigrees and the direction of diagnosis and treatment. The inpatients of the neurology department from January 2012 to December 2020 in Hunan Children's Hospital were retrospectively analyzed. There were 36,777 patients enrolled in this study. The next analysis was based on factors like age, gender, length of stay (LoS), number of patients per month and per year (MNoP and ANoP, respectively), and average daily hospital cost (ADHE). To evaluate the characteristics of neurological diseases, we applied a series of statistical tools such as numerical characteristics, boxplots, density charts, one-way ANOVA, Kruskal–Wallis tests, time-series plots, and seasonally adjusted indices. The statistical analysis of neurological diseases led to the following conclusions: First, children having neurological illnesses are most likely to develop them between the ages of 4 and 8 years. Benign intracranial hypertension was the youngest mean age of onset among the various neurologic diseases, and most patients with bacterial intracranial infection were young children. Some diseases have a similar mean age of onset, such as seizures (gastroenteritis/diarrhea) and febrile convulsions. Second, women made up most patients with autoimmune diseases of the central nervous system. Treatment options for inherited metabolic encephalopathy and epilepsy are similar, but they differ significantly for viral intracranial infection. Some neurologic diseases were found to have seasonal variations; for example, infectious diseases of the central nervous system were shown to occur more commonly in the warm season, whereas, autoimmune diseases primarily appeared in the autumn and winter months. Additionally, the number of patients admitted to hospitals with intracranial infections and encephalopathy has dramatically dropped recently, but the number of patients with autoimmune diseases of the central nervous system and hereditary metabolic encephalopathy has been rising year over year. Finally, we discovered apparent polycentric distributions in various illnesses’ density distributions. The study offered an epidemiological basis for common nervous system diseases, including evidence from age of onset, number of cases, and so on. The pedigree of nervous system diseases has significantly changed. The proportion of patients with neuroimmune diseases and genetic metabolic diseases is rising while the number of patients with infection-related diseases and uncertain diagnoses is decreasing. The existence of a disease multimodal model suggests that there is still a lack of understanding of many diseases' diagnosis and treatment, which needs to be improved further because accurate diagnosis aids in the formulation of individualized treatment plans and the allocation of medical resources; additionally, there is still a lack of effective treatment for most genetic diseases. The seasonal characteristics of nervous system diseases suggest the need for the improvement of sanitation, living conditions, and awareness of daily health care.

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Section: Discussionmentioning

confidence: 99%

The retrospective data analysis on the pedigree of nervous system diseases in children

Liu

Chen

et al. 2023

Sci Rep

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“…However, limited to the current understanding and diagnosis and treatment level, these patients may not nd the corresponding diagnostic markers. In this regard, the update of diagnostic methods will help to further con rm the accurate diagnosis of patients at an early stage, make more targeted treatment in time and improve the prognosis [9]. vi) Central nervous immune system disease tends to has longer hospitalization time and higher cost.…”

Section: Discussionmentioning

confidence: 99%

The retrospective data analysis on the spectrum of nervous system diseases in children

Liu

Chen

et al. 2022

Preprint

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Background Nowadays, the development of diagnosis and treatment technology is constantly changing the pedigree and classification of nervous system diseases. The analysis of the changes of previous disease pedigrees is helpful to understand the changes brought by accurate diagnosis of diseases from the macro direction, and predict the changes of subsequent disease pedigrees and the direction of diagnosis and treatment. Methods The in-patients in neurology department from January 2012 to December 2020 in Hunan Children's Hospital were analyzed retrospectively. There were 36777 patients were enrolled in this study. The subsequent analysis was based on variables such as Age, Gender, Length of Stay (LoS), Monthly and Annual Number of Patients (MNoP and ANoP, respectively), and Average Daily Hospitalization Expense (ADHE). To assess the characteristics of neurology diseases, we applied a series of statistical tools such as numerical characteristics, boxplot, density chart, one way ANOVA, Kruskal-Wallis test, time-series plots and seasonally adjusted indices. Results The following conclusions were drawn from the statistical analysis of neurological disease. Firstly, neurological disease in children mainly appear between the ages of 4 and 8 years. Among various neurological diseases, benign intracranial hypertension had the lowest average onset age, and most patients with bacterial intracranial infection were infants. Some diseases have similar mean onset age, such as convulsion and febrile convulsion. Secondly, most patients with central nervous system autoimmune disease were women. Hereditary metabolic encephalopathy is highly similar in terms of treatment options, while viral intracranial infection and epilepsy is in contrast, with obvious heterogeneity in treatment. It was noted that some neurological diseases showed seasonality, for example, central nervous system infectious disease was more frequent in high temperature season, while autoimmune disease mainly appeared in autumn and winter. In addition, the number of patients hospitalized for intracranial infection and encephalopathy has decreased significantly in recent years, while that for central nervous system autoimmune disease and hereditary metabolic encephalopathy has been increasing year by year. Finally, we found obvious polycentric distributions in the density distributions of some diseases. Conclusion The study provided an epidemiological basis for common nervous system diseases, such as age of onset, number of cases and so on. The spectrum of nervous system diseases took place great changes. The number of patients with infection related diseases and uncertain diagnosis is decreasing, and the proportion of neuroimmune diseases and genetic metabolic diseases is increasing; The existence of disease multimodal model suggests that there is still a lack of understanding of the diagnosis and treatment of many diseases, which needs to be further improved, since accurate diagnosis helps to formulate individualized treatment plans and reasonably allocate medical resources; Moreover, it still lacks effective treatment for most genetic diseases; The seasonal characteristics of nervous system diseases suggest the need for the improvement of sanitation, living conditions and the awareness of daily health care.

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“…szacuje się, że 60-70% przypadków limbicznego zapalenia mózgu ma paranowotworowe podłoże [20]. W dostępnej literaturze istnieje niewiele danych liczbowych opisujących powiązania limbicznego zapalenia mózgu z procesami nowotworowymi u dzieci, wskazują one jednak, że nowotwory u dzieci są rzadszą przyczyną LE niż u dorosłych [21][22][23]28].…”

Section: Częstość Występowaniaunclassified

Limbic encephalitis in children

Kamiński,

Paprocka

2024

Neurol Dziec.

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Limbiczne zapalenie mózgu (LE, limbic encephalitis) jest coraz częściej rozpoznawanym kliniczno-patologicznym zespołem objawów o podłożu immunologicznym, w którym występują zaburzenia psychiczne, poznawcze, napady ogniskowe z zaburzeniami świadomości lub bez nich oraz uogólnione napady padaczkowe. W przeszłości LE uważano za chorobę rzadką, najczęściej paranowotworową, o niekorzystnym rokowaniu. Jednak dzięki odkrywaniu nowych przeciwciał skierowanych przeciwko białkom powierzchniowym lub synaptycznym komórek, wiadomo, że w znacznej części przypadków LE nie ma związku z jakimkolwiek nowotworem złośliwym i wiąże się z dobrym rokowaniem w przypadku wczesnego zastosowania odpowiedniego leczenia.

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Autoimmune Encephalitis in Children: From Suspicion to Diagnosis

Cited by 6 publications

References 37 publications

The retrospective data analysis on the pedigree of nervous system diseases in children

The retrospective data analysis on the pedigree of nervous system diseases in children

The retrospective data analysis on the spectrum of nervous system diseases in children

Limbic encephalitis in children

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