Submit request or call to make an appointment.
Children of all ages can have autoimmune diseases that affect the nervous system. Autoimmune diseases, including autoimmune encephalitis, can occur following an infection. They also can be related to a systemic autoimmune disease or a dysfunctional immune system, or no clear health issue.
Michael L. Sweeney, M.D., with Norton Children’s Neuroscience Institute, affiliated with the UofL School of Medicine, completed his fellowship training in autoimmune neurology at the University of Utah, Salt Lake City. He is a part of the Autoimmune Encephalitis Alliance, a network of physicians dedicated to treating this disease.
Encephalitis is a disease that causes inflammation in the brain. Depending on the parts of the brain affected, symptoms can vary widely. Symptoms may include:
There are several different types of encephalitis. When encephalitis occurs without a clear reason, it is called autoimmune encephalitis. Postinfectious encephalitis occurs after an infection. If encephalitis occurs with a tumor or cancer, it is called paraneoplastic encephalitis.
Anti-NMDA receptor encephalitis is the most common form of autoimmune encephalitis in children. It is caused by the presence of antibodies in a specific part of the nerve cells in the brain, called NMDA receptors. In children, this form of encephalitis can be associated with a tumor called an ovarian teratoma, but it is very rare.
Diagnosing autoimmune encephalitis can be challenging. Our team’s first step is to do a thorough medical workup of your child. We will document his or her complete medical history and perform tests, including a neurological examination, magnetic resonance imaging of the brain (MRI), electroencephalography (EEG) and spinal fluid analysis.
Our team typically will do blood testing to evaluate your child for signs of inflammation and autoimmune disorders. We also may test for specific antibodies in the blood and spinal fluid, which can be helpful in making a diagnosis. The presence of a specific antibody is not necessary to make a diagnosis. We also may screen for an underlying tumor, which typically involves whole-body imaging.
Treatment in the hospital is aimed at reducing the amount of inflammation within your child’s brain. Our team may use high doses of steroids, intravenous immunoglobulin and plasmapheresis. If needed, your child also may receive additional immunotherapies, such as rituximab or cyclophosphamide.
Our team may use medications to treat symptoms caused by encephalitis. If your child has seizures, we may prescribe antiepileptic medications. For mood changes, we may prescribe antipsychotic and antidepressant medications.
Long-term follow-up care with our team is important to address possible consequences of encephalitis, such as seizures, mood and personality changes, and learning difficulties.