AUTOIMMUNE ENCEPHALOPATHIES. DESCRIBING TWO CLINICAL CASES
Exact clinical diagnosis in patients with epileptic attacks and its subsequent clear classification are extremely important for treatment and prognosis. Within the last years they started using such terms as genetic, structural/metabolic epilepsies and epilepsy with unknown etiology when describing epilepsy etiology [1]. It is believed that epilepsy of unknown etiology constitutes about 30% of all cases of epilepsy in adults [2] and 23-35% of children. They belong to an important group to reveal new etiological factors and mainly specific changes on the part of the immune system. Autoimmune mechanisms of epilepsy attacks acquire even greater importance and are often diagnosed in children. Such disorders as myasthenia gravis, Eaton-Lambert syndrome, multiple sclerosis, acute disseminated encephalomyelitis (ADEM), limbic encephalitis, Rasmussen’s encephalitis, Davic’s disease etc. in which the autoimmune mechanisms were proven. Clinical symptoms of autoimmune diseases of the central nervous system depend on where cerebral lesions are localized and are of polymorphic character such as epileptic seizures, motor, psychic and cognitive disturbances, vegetative disturbances and sleep disorders. The article mentions two clinical examples of autoimmune encephalitis in children that occurred approximately at the same age but with various clinical symptoms and therapeutic outcomes. The assumed mechanisms of autoimmune disturbances in the diseases of the nervous system and a classification of autoimmune encephalitis and brief clinical peculiarities of the most frequently diagnosed forms are presented.