Autoimmune encephalitis 

Autoimmune encephalitis is a term that refers to a group of disorders in which the body's immune system attacks and inflames the brain. Antibodies are proteins produced by the immune system that mistakenly strikes brain cells. Because inflamed brain tissues don't work correctly, the child might have seizures, mental confusion, or behavioral abnormalities.

Infection or inflammation of the brain can cause long-term damages. Unfortunately, the long-term repercussions of autoimmune encephalitis are impossible to anticipate. Some kids have various severe symptoms but react positively to treatment. Others have less severe symptoms but suffer from epilepsy and experience long-term learning difficulties. 

Signs and Symptoms of Autoimmune Encephalitis 

Some of the factors that can influence the signs and symptoms of autoimmune encephalitis in children include; 

• The portion of the brain that is inflamed
• The origin of the inflammation
• The extent of inflammation
• The child's age
• Other health concerns

Sometimes, even the minors in the same situation may exhibit symptoms in varying ways. The following are some of the most prevalent encephalitis symptoms: 

• Fever
• Headache
• A light sensitivity
• Stiffness in the neck
• Rashes on the skin
• Nausea and vomiting
• Changes in alertness causing sleepiness
• Loss of appetite and energy 
• Confusion or hallucinations
• Difficulty in communicating
• Issues with walking
• Seizures

Because autoimmune encephalitis commonly occurs due to a virus, symptoms may arise alongside or after other virus symptoms. These can include an upper respiratory illness, including a cold or sore throat, or a gastrointestinal disorder such as diarrhea, vomiting, nausea, or rash. 

Causes of Autoimmune Encephalitis 

The leading causes of autoimmune encephalitis are viruses. Some of the common viruses include; 

• Herpes simplex virus: This is one of the main causes of autoimmune encephalitis. The majority of the children get exposed to this kind of virus, and the child could be infected even if they don't have a cold sore, blister in their mouth, or any other symptoms. 
• Enteroviruses: There are forms of viruses that get into the body via the digestive tract and can lead to hand, foot, and mouth disease.
• Viruses that cause measles, rubella, mumps, and chickenpox: Ensuring that your child's vaccines are up to date reduces the risk of autoimmune encephalitis caused by these viruses. 

Autoimmune encephalitis can as well be caused by disease-carrying agents such as;  

• Mosquitos (West Nile virus)
• Ticks (Lyme disease)
• Cats (Bartonella, also called cat-scratch disease)

Exposures to other animals, environmental exposures like swimming in fresh-water bodies and traveling to specific regions can also contribute to the condition. 

When to See a Doctor 

If you or your child is suffering any of the most severe symptoms of autoimmune encephalitis, seek medical help right away. A severe headache, a fever, and a change in consciousness necessitate immediate medical attention.

In addition, any signs or symptoms of encephalitis in infants and younger children should be treated immediately.

Risk Factors of Autoimmune Encephalitis 

Both children and adults can get autoimmune encephalitis. The following are some of the risk factors that can contribute to encephalitis; 

Age: In some age groups, certain forms of autoimmune encephalitis are more common or severe. Various types of viral encephalitis put younger children and older individuals at a higher risk.

Weak immune system: Encephalitis is more likely in those with HIV/AIDS, those who use immune-suppressing medicines, or have another illness that weakens the immune system.

Regions of the world: Viruses spread by mosquitos or ticks are frequent in some geographical areas. 

The time of year: In many parts of the United States, mosquito- and tick-borne diseases are more prevalent during the summer.

Autoimmune Encephalitis Diagnosis 

A pediatric neurologist or doctor can diagnose autoimmune encephalitis by first looking at the symptoms of the child. If they suspect the condition, they can also conduct one or more diagnostic tests and procedures such as; 

CT or MRI scans of the brain:

The physicians can use CT scans and MRIs to identify structural changes within the brain. They can rule out alternative possibilities for symptoms like a tumor and a stroke. Some viruses have a proclivity for infecting certain parts of the brain. Therefore, it's possible to tell the type of virus your child has by looking at the affected sections of the brain.

Spinal tap or lumbar puncture: 

This procedure involves inserting a needle into the lower back to take a small amount of cerebrospinal fluid (CSF). CFS is the protective fluid surrounding the brain as well as the spinal column. Infection and inflammation of the brain might be indicated by changes in this fluid. CSF samples can sometimes be examined to determine the virus and other infectious agents. 

Electroencephalograph (EEG): 

An EEG records the activity of the brain using electrodes (tiny metallic discs with wires) affixed to the scalp. The virus that triggers encephalitis is not detectable by an EEG. However, specific patterns on the EEG might alert the neurologist of an infectious root of the symptoms. Later stages of autoimmune encephalitis might cause seizures or coma. As a result, the EEG is critical in identifying the damaged parts of the brain and the brain waves types that happen in each location. 

Blood tests:

Pediatric neurologists can sometimes use blood tests to check for viral infection signs. Blood tests are not usually done on their own. They are frequently used in conjunction with other tests to help diagnose encephalitis.  

Brain biopsy: 

The physician will extract small samples of brain tissue for infection testing during a brain biopsy. Because of the significant risk of complications, this technique is rarely used. It's normally performed only when the neurologist can't figure out what's causing the brain swelling or when other treatments aren't effective. 

Autoimmune Encephalitis Treatment 

Autoimmune encephalitis treatment should begin as soon as possible. The child must be admitted to a hospital so that he or she will be thoroughly monitored. In most cases, your child's treatment will be determined by his or her symptoms, age, and overall health. It will also be determined by the severity of the disease. 

The treatment's goal is to minimize the swelling in the brain while also avoiding severe complications. 

Antiviral medications:

To halt the infection and reduce seizures or fever, the child has to take antiviral medications. Examples of the common antiviral drugs that pediatricians recommend to treat autoimmune encephalitis include; 

• Acyclovir (Zovirax)
• Foscarnet (Foscavir)
• Ganciclovir (Cytovene)

Insect-borne viruses, for example, are resistant to these forms of treatment. However, since the exact virus may not be recognized soon or at all, physicians frequently prescribe acyclovir treatment. Acyclovir is effective against HSV, which can cause serious complications if not treated early. 

Other encephalitis treatment options include;

• Assistance with breathing, such as supplemental oxygen or use of a breathing machine (mechanical ventilation).
• Immunomodulators; these are drugs that reduce the severity of body immune system attacks.
• Fluids administered intravenously (IV) to make the patient hydrated.
• Steroids to treat swelling and pressure in the brain.
• Tube feeding; if you are unconscious, you will be fed through a tube.

Follow up therapy:

If the child has autoimmune encephalitis complications, he or she may require more therapies. They can include;

Physical therapy: Strength, balance, flexibility, motor coordination, and movement can improve with physical therapy.

Speech therapy: This helps to retrain muscular control as well as coordination so that speech can be normal again.

Occupational therapy: This enables patients to develop their daily skills and employ adaptive things to aid them in their usual tasks.

Psychotherapy: This improves mood problems or deals with personality changes by learning coping techniques and behavioral skills.

Complications of Autoimmune Encephalitis 

The majority of minors who have severe autoimmune encephalitis will develop some complications. Encephalitis can thus cause a variety of complications, including:

• Personality or behavioral changes 
• Memory loss 
• Epilepsy 
• Physical weakness 
• Fatigue 
• Intellectual disability 
• Vision and hearing problems 
• Physical weakness 
• Communication problems 
• Breathing difficulties 
• Coma and even death 

Preventing Autoimmune Encephalitis 

The best method to prevent getting viral encephalitis is to avoid being exposed to viruses that might contribute to it. Therefore, you can consider the following preventive measures;

Maintain a healthy level of hygiene: Cleaning hands with soap and water regularly and thoroughly, especially after using the restroom and before and after eating, can help prevent encephalitis.  

Avoid sharing utensils: Tableware and beverages should not be shared.

Educate children on good habits: Ensure kids maintain proper hygiene while at home and school, and do not share utensils.

Opt for vaccination: Ensure that you and your children's vaccines are up to date. Before you travel, consult your doctor about the vaccinations that are suitable for particular destinations.

Conclusion 

Autoimmune encephalitis is a form of brain inflammation. It frequently produces relatively minor flu-like symptoms, including fever or headache, or lack of symptoms at all. The flu-like symptoms can be more severe at times. This condition can also result in muddled thinking, seizures, and issues with mobility or senses like vision and hearing.

Encephalitis can be life-threatening in some situations. Because it's difficult to predict how encephalitis may impact each child, prompt diagnosis and treatment are critical.