Authors: P. Mikolášek 1; Š. Aulická 2; L. Homola 1; J. Štěrba 3; J. Bednářová 4; L. Krbková 1 Authors place of work: LF MU a FN Brno Klinika dětských infekčních nemocí 1; LF MU a FN Brno Klinika dětské neurologie 2; LF MU a FN Brno Klinika dětské onkologie 3; LF MU a FN Brno Oddělení klinické mikrobiologie 4 Published in the journal: Cesk Slov Neurol N 2017; 80/113(2): 224-227 Category: Kazuistika doi: https://doi.org/10.14735/amcsnn2017224
Autoimmune encephalitis is a rare condition of the central nervous system in children. In cases of primary involvement of the limbic system structures with corresponding clinical symptoms, we use the term limbic encephalitis. They occur as part of paraneoplastic symptoms or as autoimmune inflammation of the limbic system structures. The spectrum of non-specific symptoms can lead to misdiagnosis with improperly selected therapy and sequelae for the patient. We present a case of a 15-year-old patient with an autoimmune form of anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis. The primary manifestation was de novo epileptic paroxysmus with subacutely evolving and progressing qualitative impairment of consciousness. Aseptic inflammation in the cerebrospinal fluid led to a suspicion of infectious meningoencephalitis. Diagnosis of anti-NMDAR encephalitis was confirmed by the presence of antibodies in the cerebrospinal fluid and in the serum. Following acute deterioration of the condition, it was necessary to intensify therapy with corticosteroids, plasmapheresis, immunoglobulins, immunosuppressives and biological treatment. Despite complications, including impaired vital functions, the patient was cured without permanent sequelae.
Key words: limbic encephalitis – paraneoplastic antibodies – anti-NMDAR The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.
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