Anti-NMDAR encefalitida v dětském věku – kazuistika

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Title in English Anti-NVDAR Encephalitis in Children - a Case Report
Authors

MIKOLÁŠEK Peter AULICKÁ Štefánia HOMOLA Lukáš ŠTĚRBA Jaroslav BEDNÁŘOVÁ Jana KRBKOVÁ Lenka

Year of publication 2017
Type Article in Periodical
Magazine / Source Česká a slovenská neurologie a neurochirurgie
MU Faculty or unit

Faculty of Medicine

Citation
Web https://www.csnn.eu/en/journals/czech-and-slovak-neurology-and-neurosurgery/2017-2-3/anti-nmdar-encephalitis-in-children-a-case-report-60569?hl=cs
Doi http://dx.doi.org/10.14735/amcsnn2017224
Field Neurology, neurosurgery, neurosciences
Keywords limbic encephalitis; paraneoplastic antibodies; anti-NMDAR
Description 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.
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