ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG VIÊM NÃO TỰ MIỄN KHỞI PHÁT SAU VIÊM NÃO VI RÚT Ở TRẺ EM

Abstract

Objective: This study aims to describe the clinical and subclinical characteristics of autoimmune encephalitis following viral encephalitis in children. Subjects and Methods: A cross-sectional descriptive study was conducted on 35 pediatric patients diagnosed with autoimmune encephalitis following viral encephalitis in children at the National Children's Hospital. Results: Between January 2019 and June 2024, 35 patients with a median age of 5 years (IQR 1 – 9 years) were included in the study, with the majority being children under 5 years old (57.1%). The male-to-female ratio was 1.9:1. The most common viruses causing the onset of the disease were HSV (57.1%), JEV (34.3%), and EV (8.6%). The median time to onset of autoimmune encephalitis after a viral encephalitis episode was 21 days (IQR: 15 – 30 days). Clinical presentations of autoimmune encephalitis were diverse, with relapse fever (62.9%), movement disorders (62.9%), and recurrent unconsciousness (48.6%) being the most common symptoms. Cerebrospinal fluid abnormalities were observed in 77.1% of patients, with the majority showing hypercytosis (71.4%) and increased protein levels (57.1%). Autoimmune antibody testing in cerebrospinal fluid revealed that 62.9% of patients were positive for NMDA receptor antibodies. EEG abnormalities in background brain activity were found in 88.6% of the cases. Most patients also had old lesions on their MRI scans (88.6%), which were located in various areas, with the parietal lobe (34.3%) and temporal lobe (34.3%) being the most common locations. New lesions were rarely observed. The study concluded that autoimmune encephalitis in children can be triggered by several viruses, including HSV, JEV, and EV. The disease presents with diverse clinical symptoms, often including recurrent fever, movement disorders, and decreased consciousness