Е.Yu. GORELIK¹, N.V. SKRIPCHENKO^1,2, S.V. LAPIN³, A.A. VILNITS^1,2, E.Yu. SKRIPCHENKO^1,2, A.V. ASTAPOVA¹, N.V. MARCHENKO¹, V.B. VOITENKOV¹, A.N. MOSHNIKOVA³

¹Pediatric Research and Clinical Center for Infectious Diseases, Saint Petersburg

²Saint Petersburg State Pediatric Medical University, Saint Petersburg

³First I. Pavlov State Medical University, Saint Petersburg

  Contact:

Gorelik E.Yu, PhD (medicine), Senior Researcher of the Department of Neuroinfections and organic pathology of nervous system, Acting Head of the Department of Neuroinfections and organic pathology of nervous system

Address: 9 Professor Popov Str., 197022, Saint Petersburg, Russian Federation, tel. +7-921-346-55-37, e-mail: e.gorelik@mail.ru

The frequency and nosological diversity of autoimmune diseases of the nervous system increases every year, however, their exact prevalence has not been established. This is due to both
The frequency and nosological diversity of autoimmune diseases of the nervous system increases every year, however, their exact prevalence has not been established. This is due to both clinical polymorphism and the complexity of laboratory diagnostics, and lack of awareness of doctors of various specialties about this pathology. The disease is due to the production of antineuronal antibodies under a neoplastic or infectious process, and parainfection diseases are more common in children. The most common neurological disorders associated with antibodies to glutamate decarboxylase (anti-GAD AT) in children are limbic encephalitis and resistant epilepsy. Differential diagnosis is facilitated by the identification of laboratory or radiological signs of inflammation in brain and the detection of specific anti-GAD antibodies in blood and / or cerebrospinal fluid.Treatment is based on immunosuppressive therapy (glucocorticoids, intravenous immunoglobulins, plasmapheresis), and the effectiveness of treatment depends on the time of its initiation. The feasibility of immunotropic therapy in cases of suspected autoimmune nature of the disease is discussed, without waiting for laboratory confirmation of the diagnosis. Clinical case of a child with encephalitis with anti-GAD AT, symptomatic epileptic seizures and aphasia is presented. The effectiveness of the timely started complex therapy, including immunosuppressive, neurometabolic and anticonvulsant drugs that contributed to recovery, is demonstrated, which is clinically confirmed by instrumental (MRI , EEG) studies.

Key words: glutamic acid decarboxylase (GAD), autoimmune encephalitis, epilepsy, children.

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