Neuropsychological Outcomes at Disease Onset and One Year Follow-up in a Case Series of Children with Autoimmune Encephalopathies

Pownall, J., Thomson, A., Fisk, C., Adey, C., MacLeod, S., Horrocks, I., Zuberi, S.M. and Dorris, L. (2015) Neuropsychological Outcomes at Disease Onset and One Year Follow-up in a Case Series of Children with Autoimmune Encephalopathies. 11th EPNS Congress, Vienna, Austria, 27-30 May 2015. S110. (doi:10.1016/S1090-3798(15)30371-8)

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Abstract

Objective: Autoimmune encephalitis refers to an immune-mediated inflammation of the brain, resulting in a wide range of neurological and psychiatric symptoms. We present clinical data alongside the results of serial neuropsychological assessments of children with three types of encephalitis (Hashimoto's encephalopathy, NMDAR-ab and VGKC-ab). Methods: Six children presenting to a paediatric neurosciences centre at the Royal Hospital for Sick Children, Glasgow, Scotland were assessed during the acute stage of their illness as in-patients and subsequently for neuropsychological reviews as out-patients. There were two children with Hashimoto's encephalopathy, two children with voltage gated potassium channel antibodies (VGKC-ab), and two children with NMDA receptor antibody (NMDAR-ab). All were treated with immune modulating therapy in the acute and recovery phase of their illness. Average age at first assessment using the WISC-IV (UK) and Childrens Memory Scale (CMS) was 12 years 2 months (SD 2.2) with a median latency to follow-up of 15 months from acute presentation. There was only one male participant (VGKC-ab). Results: Full-Scale IQ scores were available for 5 participants. During admission 2/5 scored within the borderline range (5th and 8th percentile), 1/5 within the low average range (19th percentile), and 2/5 within the average range (66th and 73rd percentile). Only 2/5 showed a significant increase in scores at follow-up (borderline to low average; average to superior). There was significant variation within the different indices of the WISC-IV (VCI, PRI & WMI) indicating differential recovery of cognitive functions. CMS (verbal memory) scores were available for 5 participants. 3/5 scored in the impaired range during acute admission, and only 2/5 showed any improvement at follow-up. Conclusion: Despite recent improvements in detection, early diagnosis and treatment of children with autoimmune encephalopathies there is a significant burden of cognitive disability and neuropsychiatric disorders in survivors, who require significant longer-term psychosocial intervention.

Item Type:Conference or Workshop Item
Additional Information:Abstract published in European Journal of Paediatric Neurology 19(S1):S110.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Zuberi, Dr Sameer and Dorris, Dr Liam
Authors: Pownall, J., Thomson, A., Fisk, C., Adey, C., MacLeod, S., Horrocks, I., Zuberi, S.M., and Dorris, L.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Mental Health and Wellbeing
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:European Journal of Paediatric Neurology
ISSN:1090-3798

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