Reporter: Wu Shun-Yong
Though rare, childhood encephalitis can be life-threatening. Once diagnosed, patients often require admission to intensive care units for continuous neurological monitoring and advanced treatment. Dr. Li-Wen Chen from the Department of Pediatrics at National Cheng Kung University Hospital explains that most cases of childhood encephalitis have unknown causes, with some linked to central nervous system infections.
Dr. Chen noted that recent studies have shown autoimmune antibodies attacking neural cells can also cause encephalitis. While rare, untreated cases can be fatal. However, with accurate diagnosis and timely immunotherapy, patients have a high chance of full recovery.
In late 2024, a 5-year-old girl was brought to the hospital after previously being treated for meningitis and seizures. Despite seizure control, her family noticed increasing irritability, sudden silence, abnormal limb movements, and altered mental responses.
The pediatric team at the hospital evaluated her condition, observing multiple neurological symptoms over several weeks—such as psychiatric disturbances, language impairment, movement disorders, seizures, and altered consciousness. As no infectious pathogen was identified, autoimmune encephalitis was strongly suspected. A cerebrospinal fluid test confirmed anti-NMDA receptor encephalitis. She received high-dose steroids and intravenous immunoglobulin (IVIG). Within five days, her language and motor functions improved, and her mood stabilized. Post-discharge follow-ups showed full recovery in cognition and learning, and anti-seizure medication was discontinued. She has since resumed normal life and school.
Dr. Chen explained that autoimmune encephalitis is a neuroimmunological condition in which antibodies mistakenly target neurons as foreign bodies, triggering inflammation in the brain. Symptoms in children are diverse and include psychiatric disturbances, language regression, unusual movements, seizures, and altered consciousness. Without timely treatment, the condition can progress within a month to autonomic dysfunction, leading to life-threatening issues like arrhythmias or respiratory failure. However, early diagnosis and immunotherapy greatly reduce the risk of deterioration. Even in advanced stages, aggressive second-line immunomodulatory therapy can lead to full recovery.
Dr. Chen emphasized that the field of neuroimmunology has only developed over the past two decades, and comprehensive diagnostic and treatment guidelines are still lacking. Knowledge and research in autoimmune encephalitis must continue to align with global advancements. NCKU Hospital has a well-established pediatric neurology and critical care team that actively applies neuroimmunological expertise in clinical care to improve diagnosis accuracy and provide timely, precision treatment for patients.
Source: Taiwan Good News, June 5, 2025
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