engleski

Clinical manifestations of the autoimmune process of central nervous system

Background: Pediatric infection triggered Autoimmune Neu¬ropsychiatric Disorders are described in the literature since 1.998. Autoimmune limbic encephalitis is recognized as a precipitating factor of onset temporallobe seizures. Aim: two case reports of children with autoimmune neuropsychiatric disorders. First case: K.L., 13 years old girl was hospitalized for the third cime because she had fever, ataxia, psychomotor seizures, bizarre gait and abnorrnai choreiforrn movements, catatonia, dysarthric speech and communication only in German .anguage with often changes in mood and hallucinations. Previous hospitalization was two weeks earlier because she had a painful right mastoid. First hospitalization was two years earlier because of right mastoids infection and right retrobulbar neuritis. Now the EEG showed the focus of the slow waves on the right temporal, and later on both sides in temporoparietal region ; oligodonal bands in CSF were positive ; MS CT of pyramids showed chronic inflammatory changes right and psychological testing showed deficits in cognitive functions. She was treated with antibiotics, steroids, benzodiazepines and carbamazepine. The patient underwent exploratory antrotomy of the right ear. After that she had started to recover. Second case: In l6-year-old girl non-paraneoplastic lim¬bic encefalitis was diagnosed. Immune thrombocytopenia manifested in chronic form had been diagnosed 11 years earlier. She had complex partial seizures and developed behavioral disturbances: anxiety, feeling of unreality, auditory hallucinations and insomnia. EEG showed frontal fast beta activity. MRI scans demonstrated a temporal swelling. Cere¬brospinal fluid showed pleocytosis and positive oligodonal bands. The serologycal tests for neurotropic viruse were negative. Immunomodulation therapy was followed by an improvement of clinical status.

mmunomodulation therapy; retrobulbar neuritis; non-paraneoplastic limbic encefalitis

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