Neuroinflammatory syndromes in children

Abstract

Purpose of reviewNeuropsychiatric symptoms due to paediatric neuroinflammatory diseases are increasingly recognized and reported. Psychiatrists are crucial in front-lines identification, diagnosis and care of individuals with disorders such as autoimmune encephalitis and management of long-term neurobehavioral sequelae. This review summarizes recent literature on autoimmune and post-infectious encephalitis, discusses special considerations in children with neurodevelopmental conditions and presents a paradigm for evaluation and management. Recent findingsThere is a growing body of evidence on neuropsychiatric symptom burdens of paediatric neuroinflammatory diseases. A particular development is the evolution of diagnostic and treatment guidelines for conditions such as autoimmune encephalitis, which take into account phenotypes of acute, short-term and long-term sequelae. Interest in inflammatory sequelae of viral illness, such as SARS-CoV-2, in children remains in early development. SummaryNeuroimmunological disease data are constantly evolving. New recommendations exist for multiple common neuroimmunological disorders with behavioural, emotional, cognitive and neurological sequelae. Anti-NMDA receptor encephalitis now has well-recognized patterns of symptom semiology, diagnostic and treatment recommendations, and outcome patterns. Recognizing psychiatric symptoms heralding autoimmune brain disease and understanding neuropsychiatric sequelae are now a crucial skill set for paediatric psychiatrists. Exploration of inflammatory features of other diseases, such as genetic syndromes, is a burgeoning research area.

Cyclizine‐induced proinflammatory responses through Akt‐NFκB pathway in macrophages

“…[21][22][23][24] Cognitive decline, confusion, impaired motor abilities, tremors, sensory changes, ataxia, and seizures are symptoms of neuroinflammatory and neurovegetative diseases such as stroke, Parkinson's disease, Alzheimer's disease, multiple sclerosis, and epilepsy. [25][26][27] The adverse responses to cyclizine are similar to such symptoms, which are induced by macrophage activation. In this study, we found that cyclizine induced the generation of proinflammatory cytokines (i.e., TNF-α, IL-1β, and IL-6) in RAW264.7 macrophage cells.…”

“…However, macrophage overactivation can also lead to acute and chronic inflammatory diseases, such as neuroinflammation, neurodegenerative disease, inflammatory bowel disease, pneumonia, and pulmonary fibrosis 21–24 . Cognitive decline, confusion, impaired motor abilities, tremors, sensory changes, ataxia, and seizures are symptoms of neuroinflammatory and neurovegetative diseases such as stroke, Parkinson's disease, Alzheimer's disease, multiple sclerosis, and epilepsy 25–27 . The adverse responses to cyclizine are similar to such symptoms, which are induced by macrophage activation.…”