Vol 33, No 61 (2023): Continuous Publishing
Review paper
Published online: 2024-03-28
Limbic encephalitis in children
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DOI: 10.5603/cne.98975
Neurol Dziec 2023;33(61):41-53.
Abstract
Limbic encephalitis (LE) is an increasingly recognised clinicopathological syndrome with an immunological basis. It is most often subacute with psychiatric and cognitive impairment, focal seizures with impaired consciousness or generalised epileptic seizures. In the past, LE was considered a rare disease, usually paraneoplastic, with an unfavourable prognosis. However, with the discovery of new antibodies against cell surface or synaptic proteins, it is now known that in a significant proportion of cases LE is unrelated to any malignancy and is associated with a good prognosis if appropriate treatment is administered early.
Keywords: autoimmune encephalitischildrenetiologyclinical picturediagnostic criteriadifferential diagnosistreatment
References
- Osten-Sacken K, Jasińska-Mikołajczyk A, Malewska M, et al. Case report of limbic encephalitis with anti-NMDA antibodies. Neuropsychiatria i Neuropsychologia. 2017; 2: 80–85.
- Collao-Parra J, Romero-Urra C, Delgado-Derio C. Encefalitis autoinmunes: criterios diagnósticos y pautas terapéuticas. Rev Méd Chile. 2018; 146(3): 351–361.
- Czupryna P, Zajkowska J. Limbiczne zapalenie mózgu wywołane przez wirusa HHV-6. Neurologia po Dyplomie. 2014; 9(2): 27–30.
- Cellucci T, van Mater H, Graus F, et al. Clinical approach to the diagnosis of autoimmune encephalitis in the pediatric patient. Neurol Neuroimmunol Neuroinflamm. 2020; 7(4): e663.
- Yang J, Liu X. Immunotherapy for Refractory Autoimmune Encephalitis. Front Immunol. 2021; 12: 790962.
- Machado S, Pinto AN, Irani SR. What should you know about limbic encephalitis? Arq Neuropsiquiatr. 2012; 70(10): 817–822.
- Michalak S. Klasyfikacja i rozpoznawanie neurologicznych zespołów paranowotworowych. Pol Przegl Neurol. 2008; 4(4): 163–167.
- Uy CE, Binks S, Irani SR. Autoimmune encephalitis: clinical spectrum and management. Pract Neurol. 2021; 21(5): 412–423.
- Ancona C, Masenello V, Tinnirello M, et al. Autoimmune encephalitis and other neurological syndromes with rare neuronal surface antibodies in children: a systematic literature review. Front Pediatr. 2022; 10: 866074.
- Ibrahim Ismail I, K John J, Ibrahim M, et al. Paraneoplastic Limbic Encephalitis Associated with Anti-CV2/CRMP5 Antibodies Secondary to Thymoma in an Adolescent. Case Rep Neurol. 2020; 12(1): 50–55.
- Armangue T, Leypoldt F, Dalmau J. Autoimmune encephalitis as differential diagnosis of infectious encephalitis. Curr Opin Neurol. 2014; 27(3): 361–368.
- Wagner JN, Kalev O, Sonnberger M, et al. Evaluation of clinical and paraclinical findings for the differential diagnosis of autoimmune and infectious encephalitis. Front Neurol. 2018; 9: 434.
- Budhram A, Leung A, Nicolle MW, et al. Diagnosing autoimmune limbic encephalitis. CMAJ. 2019; 191(19): 529–E534.
- Garg D, Mohammad SS, Sharma S. Autoimmune encephalitis in children: an update. Indian Pediatr. 2020; 57(7): 662–670.
- da Rocha AJ, Nunes RH, Maia ACM, et al. Recognizing autoimmune-mediated encephalitis in the differential diagnosis of limbic disorders. AJNR Am J Neuroradiol. 2015; 36(12): 2196–2205.
- Esposito S, Autore G, Argentiero A, et al. Autoimmune encephalitis after herpes simplex encephalitis: A still undefined condition. Autoimmun Rev. 2022; 21(12): 103187.
- Dubey D, Pittock SJ, Kelly CR, et al. Autoimmune encephalitis epidemiology and a comparison to infectious encephalitis. Ann Neurol. 2018; 83(1): 166–177.
- Sabanathan S, Abdel-Mannan O, Mankad K, et al. Clinical features, investigations, and outcomes of pediatric limbic encephalitis: a multicenter study. Ann Clin Transl Neurol. 2022; 9(1): 67–78.
- Steinborn B. Neurologia wieku rozwojowego. PZWL, Warszawa 2021.
- Derry CP, Wilkie MD, Al-Shahi Salman R, et al. Autoimmune limbic encephalitis. Clin Med (Lond). 2011; 11(5): 476–478.
- Hon KL, Leung AK, Au CC, et al. Autoimmune encephalitis in children: from suspicion to diagnosis. Cureus. 2021; 13(2): e13307.
- Haberlandt E, Bast T, Ebner A, et al. Limbic encephalitis in children and adolescents. Arch Dis Child. 2011; 96(2): 186–191.
- Honnorat J, Didelot A, Karantoni E, et al. Autoimmune limbic encephalopathy and anti-Hu antibodies in children without cancer. Neurology. 2013; 80(24): 2226–2232.
- Ding JB, Dongas J, Hu K, et al. Autoimmune limbic encephalitis: a review of clinicoradiological features and the challenges of diagnosis. Cureus. 2021; 13(8): e17529.
- Barbagallo M, Vitaliti G, Pavone P, et al. Pediatric autoimmune encephalitis. J Pediatr Neurosci. 2017; 12(2): 130–134.
- Gaig C, Graus F, Compta Y, et al. Clinical manifestations of the anti-IgLON5 disease. Neurology. 2017; 88(18): 1736–1743.
- Juneja M, Kaur S, Mishra D, et al. Ophelia syndrome: Hodgkin lymphoma with limbic encephalitis. Indian Pediatr. 2015; 52(4): 335–336.
- Armangue T, Petit-Pedrol M, Dalmau J. Autoimmune encephalitis in children. J Child Neurol. 2012; 27(11): 1460–1469.
- Sánchez-Larsen Á, de Cabo C. Seronegative limbic encephalitis. Neurol Sci. 2020; 41(1): 205–208.
- Deuschl C, Rüber T, Ernst L, et al. 18F-FDG-PET/MRI in the diagnostic work-up of limbic encephalitis. PLoS One. 2020; 15(1): e0227906.
- Patel A, Meng Y, Najjar A, et al. Autoimmune encephalitis: a physician's guide to the clinical spectrum diagnosis and management. Brain Sci. 2022; 12(9).
- Graus F, Titulaer MJ, Balu R, et al. A clinical approach to diagnosis of autoimmune encephalitis. Lancet Neurol. 2016; 15(4): 391–404.
- Titulaer MJ, McCracken L, Gabilondo I, et al. Treatment and prognostic factors for long-term outcome in patients with anti-NMDA receptor encephalitis: an observational cohort study. Lancet Neurol. 2013; 12(2): 157–165.
- Dalmau J, Tüzün E, Wu Hy, et al. Paraneoplastic anti-N-methyl-D-aspartate receptor encephalitis associated with ovarian teratoma. Ann Neurol. 2007; 61(1): 25–36.
- Snene H, Zayen K, Salah NB, et al. Encéphalite limbique paranéoplasique compliquant un adénocarcinome pulmonaire: à propos d´un cas. Pan Afr Med J. 2021; 39.
- Gole S., Anand A.: Autoimmune Encephalitis. In: StatPearls. Treasure Island (FL): StatPearls Publishing 2023. https://www.ncbi.nlm.nih.gov/books/NBK578203/.
- Danel-Leśkow E, Jóźwiak S. Febrile infection-related epilepsy syndrome (FIRES) –a current approach. Child Neurology. 2016; 25(51): 39–42.
- Wilbur C, Bitnun A, Kronenberg S, et al. PANDAS/PANS in childhood: Controversies and evidence. Paediatr Child Health. 2019; 24(2): 85–91.
- Yang J, Liu X. Immunotherapy for refractory autoimmune encephalitis. Front Immunol. 2021; 12: 790962.
- Wójtowicz R, Krawiec M, Orlicz P. Autoimmune anti-N-methyl-D-aspartate receptor encephalitis — the current state of knowledge based on a clinical case. Anaesthesiol Intensive Ther. 2018; 50(1): 34–39.
