Differential Diagnosis of Pediatric Autoimmune Meningioencephalitis
Single Most Likely Diagnosis
- Anti-NMDA receptor encephalitis: This is a common cause of autoimmune meningioencephalitis in pediatric patients, characterized by the presence of antibodies against the N-methyl-D-aspartate (NMDA) receptor. It often presents with psychiatric symptoms, seizures, and decreased level of consciousness.
Other Likely Diagnoses
- Acute disseminated encephalomyelitis (ADEM): ADEM is an autoimmune condition that typically follows a viral infection or vaccination, leading to demyelination in the central nervous system. It presents with symptoms such as fever, headache, confusion, and multifocal neurological deficits.
- Multiple sclerosis (MS): Although less common in pediatric patients, MS can present with symptoms of meningioencephalitis, including optic neuritis, transverse myelitis, and brainstem syndromes.
- Neuromyelitis optica spectrum disorder (NMOSD): This condition is characterized by the presence of antibodies against aquaporin-4, leading to optic neuritis and transverse myelitis. It can also present with symptoms of meningioencephalitis.
Do Not Miss Diagnoses
- Infectious meningitis: Bacterial, viral, or fungal meningitis can present with similar symptoms to autoimmune meningioencephalitis and requires prompt diagnosis and treatment to prevent serious complications or death.
- Lyme neuroborreliosis: Caused by the bacterium Borrelia burgdorferi, this condition can present with meningitis, encephalitis, and radiculoneuritis, and is often associated with a history of tick exposure.
- Subarachnoid hemorrhage: Although not an infectious or autoimmune condition, subarachnoid hemorrhage can present with sudden onset of headache, confusion, and decreased level of consciousness, and requires immediate medical attention.
Rare Diagnoses
- Hashimoto's encephalopathy: A rare condition associated with autoimmune thyroiditis, characterized by the presence of antithyroid antibodies and symptoms such as seizures, confusion, and stroke-like episodes.
- CLIPPERS (Chronic Lymphocytic Inflammation with Pontine Predominance): A rare condition characterized by chronic inflammation in the pons, presenting with symptoms such as ataxia, dysarthria, and cranial nerve palsies.
- Rasmussen's encephalitis: A rare inflammatory condition affecting one half of the brain, characterized by seizures, hemiparesis, and cognitive decline.