LGI1 encefalitida v dětském věku
| Title in English | LGI1 encephalitis in childhood |
|---|---|
| Authors | |
| Year of publication | 2023 |
| Type | Article in Periodical |
| Magazine / Source | Ceska a slovenska neurologie a neurochirurgie |
| MU Faculty or unit | |
| Citation | |
| Web | https://www.csnn.eu/en/journals/czech-and-slovak-neurology-and-neurosurgery/2023-3-9/lgi1-encephalitis-in-childhood-134908?hl=cs |
| Doi | http://dx.doi.org/10.48095/cccsnn2023208 |
| Keywords | LGI1 encephalitis; childhood |
| Description | We present a case of a pediatric patient who developed autoimmune encephalitis with anti-LGI1 (leucine-rich glioma-inactivated 1) antibody positivity. She was a previously healthy 4-year-old girl admitted to the pediatric intensive care unit for cumulative left-sided predominant faciobrachial dystonic seizures (FBDS). The development of the difficulties was preceded by signs of febrile viral illness. Brain CT, lumbar puncture (LP) and neurological findings were negative. Meningeal syndrome and signs of intracranial hypertension were not expressed. The patient was treated with levetiracetam with beneficial effect. After 2 days, a recurrence of left-sided FBDS occurred. Midazolam and valproate were administered up to the maximum therapeutic dose, and FBDS continued to recur once every 1-2 h. After adding topiramate, the seizures resolved. A psychoorganic syndrome developed, with a predominance of an excitatory component, deterioration of cognitive functions, especially memory, heteroaggression, automatization, hyperphagia, use of vulgarisms, and sleep biorhythm was disturbed. EEG showed encephalopathic recordings. MRI of the brain was negative. Psychological examination confirmed cognitive deterioration by approximately 1.5 years compared to calendar age. Basic oncological screening excluded paraneoplastic process. Re-examination of the lysate showed positivity of anti-LGI1 antibodies. |