Analysis on clinical characteristics of 36 cases of autoimmune encephalitis in children

XU Li; WANG Qianyun; SHAO Xianli; ZHANG Fan; ZHAO Huafeng

doi:10.3969/j.issn.1674-3806.2025.06.18

Abstract：Objective To analyze the clinical characteristics of autoimmune encephalitis(AE)in children.Methods A retrospective analysis was conducted on the clinical data of 36 pediatric patients with AE who were admitted to Weifang People's Hospital from May 2020 to September 2024.Their clinical manifestations,auxiliary examination results,treatments and prognosis were summarized and analyzed.Results Among the 36 patients,20 patients were male(55.56％)and 16 patients were female(44.44％).The minimum age of the patient at disease onset was 1 year,the maximum age of the patient at disease onset was 13 years and 6 months,and the average age of the patient at disease onset was(7.21±3.88)years.There were 16 patients(44.44％)with acute onset(＜1 week)and 20 patients(55.56％)with subacute onset(1 week to 3 months).Twenty-one patients(58.33％)had prodromal infection symptoms before disease onset.Epileptic seizures were the most common symptom[19 patients(52.78％)].The cerebrospinal fluid(CSF)properties and transparency of 36 patients were basically normal.The number of nucleated cells in the CSF was increased(＞5 × 106/L)in 21 patients(58.33％),and the CSF chlorine was increased(＞130 mmol/L)in 3 patients(8.33％),and abnormal CSF protein occurred in 14 patients(38.89％),and abnormal CSF glucose occurred in 7 patients(19.44％).No pathogens were found in the CSF specimens of all the patients.Among the 36 patients,anti-N-methyl-D-aspartate receptor(NMDAR)antibody was positive in 10 patients(27.78％),and anti-myelin oligodendrocyte glycoprotein(MOG)antibody was positive in 7 patients(19.44％),and anti-contactin-associated protein-like 2(CASPR2)antibody was positive in 6 cases(16.67％).Twenty-eight patients(77.78％)had electroencephalogram(EEG)abnormalities.Thirty-five patients underwent cerebral magnetic resonance imaging(MRI)examinations,among whom 14 patients(40.00％)showed abnormal manifestations.Among the patients who received immunotherapy,68.75％(22/32)of them had a complete recovery without any neuropsychiatric sequelae.Conclusion School age period is the peak period for the onset of AE in children.Its clinical manifestations mostly present with acute or subacute onset,often accompanied by a history of prodromal infection,and epileptic seizures are the most common symptom.The children with anti-NMDAR encephalitis account for the highest proportion of the children with AE.The abnormal rate of EEG in AE children is relatively high,but the abnormities lack specificity.Early standardized immunotherapy has a significant effect on most AE children.