title: Clinical Characteristics and Follow-up of South Indian Children with Autoimmune Encephalopathy.
abstract: OBJECTIVE
  To describe the clinical characteristics of a cohort of south Indian children with probable autoimmune encephalopathy from a tertiary care academic hospital and to compare this data with the existing literature.
  
  
  METHODS
  Patients with encephalopathy plus one or more of neuropsychiatric symptoms, seizures, movement disorder or cognitive dysfunction were identified. Common infectious causes were excluded. Clinical characteristics, investigations, management and outcome were analyzed.
  
  
  RESULTS
  Thirteen patients were included in the study; 12 were females (92.3 %) and mean age was 9.6 y. Most common presentation was behavior change (13 patients) followed by seizures (11 patients). Three patients showed lymphocytic pleocytosis in CSF and one patient had oligoclonal bands. Initial MRI was normal in all patients except in one. Most common EEG abnormality was mild background slowing. Only one child had ovarian tumor. S.NMDA receptor antibody was positive in 10 patients (83 %), and all of them received immunotherapy. Six out of 13 children were followed up for more than 1 y (mean - 21 mo). Recurrence was noted in 4 out of 6 patients (66 %). On last follow-up, good recovery was seen in 2 children (33 %), moderate disability in 3 (50 %) and severe disability in 1 (16 %).
  
  
  CONCLUSIONS
  The clinical characteristics and outcome of one of the largest single center cohort of Indian children with autoimmune encephalopathy is reported. Autoimmune encephalopathy should be considered as a differential diagnosis in the acute and subacute encephalopathies of childhood and treating pediatrician should be aware of this entity.
authors.affiliation: Division of Pediatric Neurology, Department of Neurology, Amrita Institute of Medical Sciences, Amrita Viswa Vidyapeetham, Kochi, India.
authors.forename: Yeeshu Singh
authors.initials: YS
authors.lastname: Sudan
authors.affiliation: Division of Pediatric Neurology, Department of Neurology, Amrita Institute of Medical Sciences, Amrita Viswa Vidyapeetham, Kochi, India. vinayankp@aims.amrita.edu.
authors.forename: K P
authors.initials: KP
authors.lastname: Vinayan
authors.affiliation: Division of Pediatric Neurology, Department of Neurology, Amrita Institute of Medical Sciences, Amrita Viswa Vidyapeetham, Kochi, India.
authors.forename: Arun Grace
authors.initials: AG
authors.lastname: Roy
authors.affiliation: Division of Pediatric Neurology, Department of Neurology, Amrita Institute of Medical Sciences, Amrita Viswa Vidyapeetham, Kochi, India.
authors.forename: Amarjeet
authors.initials: A
authors.lastname: Wagh
authors.affiliation: Department of Neurology, Amrita Institute of Medical Sciences, Amrita Viswa Vidyapeetham, Kochi, India.
authors.forename: Sudheeran
authors.initials: S
authors.lastname: Kannoth
authors.affiliation: Division of Pediatric Neurology, Department of Neurology, Amrita Institute of Medical Sciences, Amrita Viswa Vidyapeetham, Kochi, India.
authors.forename: Sandeep
authors.initials: S
authors.lastname: Patil
mesh_terms: D001327:Autoimmune Diseases / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D002648:Child; D004660:Encephalitis / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D012640:Seizures
keywords: Autoimmune; Encephalopathy; NMDAR; Seizures