Clinical, diagnostic and therapeutic aspects of autoimmune encephalitis in pediatrics: a systematic review regarding treatment with immunobiologicals

*Correspondence: [e-mail].

Abstract

Background: Autoimmune Encephalitis (AE) is a group of treatable inflammatory diseases of the CNS that affect people of all ages most of the time previously healthy. This condition occurs more frequently in immunocompetent than immunocompromised individuals and is characterized by prominent neuropsychiatric symptoms. Anti-NMDAR receptor encephalitis is one of the most common causes of AE. Patients with AE may present a variety of movement disorders, such as ataxia, dystonia, myoclonus, and orofacial dyskinesia. Seizures are the most common symptom, and different types can be observed, from focal to generalized, including refractory status epilepticus.

Objective: To list the main aspects of autoimmune encephalitis in pediatrics.

Methods: A systematic review was performed based on the PRISMA recommendations. In addition, the MEDLINE, LILACS and SciELO databases were used, as well as consultations with recent editions of relevant journals on the subject, such as the Neuropsychiatry Archives. Articles with full texts from the last 7 years, in English, Spanish and Portuguese and dealing with the issue in the pediatric age group were included.

Results: The discovery of the class of autoimmune encephalitis has changed the diagnostic and therapeutic approach to many neurological or psychiatric syndromes previously considered idiopathic. Physicians should be aware of the different laboratory evaluation methods available, as well as the proper interpretation of results. Encephalitis should be considered in the face of the sudden onset of neuropsychiatric symptoms with a variable spectrum, as early diagnosis and therapy are key factors. The treatment scheme is based on observational studies and clinical experience with anti-NMDAR encephalitis, as it is the most prevalent and most studied type. Therefore, the conduct must be individualized for each patient, considering age, whether there is a tumor and the severity of manifestations.

Conclusion: Cases that do not require intensive care and do not have an underlying tumor are also associated with a better prognosis.

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Artikel online veröffentlicht:
12. Mai 2025