Challenges to associate early onset epilepsy with COVID-19 autoimmune encephalitis:A case  

作　　者：Salma Zouari Mallouli Olfa Jallouli Wafa Bouchaala Sihem Ben Nsir Fatma Kamoun Feki Chahnez Charfi Triki 

机构地区：[1]Department of Child Neurology,Hedi Chaker Sfax University Hospital and Research Laboratory LR19ES15-University of Sfax,Tunisia,Sfax 3029,Tunisia

出　　处：《World Journal of Immunology》2023年第1期1-10,共10页世界免疫学杂志

摘　　要：BACKGROUND Diagnosis of coronavirus disease 2019(COVID-19)-related neurological events in the pediatric population is challenging.Overlapping clinical picture of children with altered neurological state and inborn errors of metabolism,in addition to the frequency of asymptomatic COVID-19 cases,pose the main challenges for diagnosis.Diagnostic approaches to the onset post-COVID 19 subacute encephalopathy are still troublesome as seronegative autoimmune encephalitis(AIE)is reported.CASE SUMMARY A 27-mo-old boy was admitted for stormy refractory seizure of polymorphic semiology and altered mental status followed by various neuropsychiatric features that were suggestive of AIE.Brain magnetic resonance imaging and cerebrospinal fluid analysis were normal.Neither the immunological assessment,including viral serologies,antinuclear antibodies,autoimmune antibodies(NMDA,AMPA,CASPR2,LG11,GABARB,Hu,Yo,Ri,CV2,PNMA2,SOX1,Titin,amphiphysin,Recoverin),nor the metabolic assessment for lactate and pyruvate showed significant anomaly.Both positive history of COVID-19 infection and the findings of characteristic repetitive extreme delta brush played a key role in the diagnosis of COVID-19-related AIE.A remarkable improvement in the state of the child was noted after two pulse doses of intravenous Veinoglobulin and high dose of intravenous Corticosteroid.CONCLUSION Diagnostic biomarkers for AIE might aid effective treatment.

关 键 词：Post-COVID-19 Auto-immune encephalitis Diagnosis biomarkers Pediatric population Delta brush sign Autoimmune antibodies 

分 类 号：R74[医药卫生—神经病学与精神病学]