Diagnostic and therapeutic challenges of autoimmune encephalitis in pediatric practice: case reports

Objective. to analyze clinical cases of children with autoimmune encephalitis (AE) to identify main diagnostic challenges and propose optimal management strategies for patients with this pathology of various origins.

Materials and methods. Clinical cases of AE in pediatric practice are presented by: Case 1 – Patient X with paraneoplastic AE; Case 2 – Patient Y with idiopathic AE. An analysis of the disease course was conducted, including evaluation of the diagnostic pathway, therapy selection, and disease outcome.

Results. During managing patients in pediatric practice, specialists face a number of difficult clinical challenges: the variability of the clinical picture in the intermittent course of encephalitis, the presence of false-positive and false-negative results of laboratory tests, nonspecific changes on neuroimaging, the inability to assess the true clinical effect of nonspecific combination drug therapy in the early stages of the disease and, as a consequence, the subsequent incorrect routing of patients.

Conclusion. Clinical and diagnostic difficulties are offset by careful collection of life history, strict adherence to the stepwise therapy, exclusion of similar pathologies through the involvement of subspecialists, as well as dynamic monitoring of the development of the clinical picture in both outpatient and inpatient settings.

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