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Eva Grudule

Riga Stradins University, Latvia

Title: Autoimmune encephalitis incidence, comparison of therapy tactics and efficiency in Children’s Clinical University Hospital from 2011-2018

Biography

Biography: Eva Grudule

Abstract

Introduction: Autoimmune encephalitis refers to a group of conditions that occur when the body's immune system mistakenly attacks healthy brain cells, leading to inflammation of the brain. The incidence of AE in US increased from 0.4 per 100,000 person-years between 1995 and 2005 to 1.2 per 100,000 person-years between 2006 and 2015. Early treatment decreases the likelihood for long-term complications, speeds recovery and reduces the risk of recurrence.

Aim: To find out the number of possible autoimmune encephalitis cases, compare therapy tactics and effectiveness in CCUH.

Method: Retrospective, descriptive analysis of data on non-infectious, possibly autoimmune encephalitis at CCUH during the years 2011-2018. Criteria for inclusion: subacute onset of altered mental status or psychiatric symptoms; CSF pleocytosis or MRI features suggestive of encephalitis; reasonable exclusion of alternative causes.

Results: Twenty-four patients (46% boys, 54% girls) aged one-17 years (average nine, one years) were included to this analysis. Acute disseminated encephalomyelitis (ADEM) was diagnosed in 13 patients, autoimmune encephalitis (AE) in 11. Ten (10) patients received treatment with i/v methylprednisolone for three-five days (ADEM-10, AE-2), 10 patients were treated with combination of several drugs (for six patients – i.v. methylprednisolone and i.v. immunoglobulin therapy, but for four patients’ immunosuppressive therapy and plasmapheresis). One patient did not receive therapy, because was stationed with relapse of AE. After treatment, 41% (n-10) of patients had no neurological symptoms at the day of discharge. Re-therapy stationary was needed for 12 patients, (50%) but re-examination for two patients (8%).

Conclusion: Immune-mediated encephalitis is a relatively rare disease in children’s but improving diagnostic capabilities the number of diagnosed cases is increasing. Early therapy is associated with a better therapeutic effect. One of the patients with delayed treatment, contiuned i.v. immunoglobulin therapy for four years.