Kết quả điều trị dài hạn bệnh viêm não tự miễn kháng thụ thể N-methyl-D-aspartate ở trẻ em

Abstract

A retrospective-prospective study was conducted on 61 pediatric patients diagnosed with anti–N-methyl-D-aspartate (NMDA) receptor autoimmune encephalitis at the National Children’ Hospital from January 2019 to August 2021, with follow-up until May 2025, to evaluate long-term treatment outcomes. The median age at onset was 7 years old (IQR: 4 - 10), where 59% were females. During the acute phase, the most common clinical manifestations were behavioral disturbances (93.4%), cognitive impairment (77.0%), and sleep disorders (75.4%). First-line immunotherapy was administered in 98.4% of patients, and 14.8% received combined second-line immunotherapy. After a mean follow-up duration of 59.8 months, 91.8% of patients achieved a favorable outcome (mRS ≤ 2), 8.2% experienced relapse, and one patient passed on (1.6%). Epilepsy occurred in 36.1% of patients, of whom 77.2% achieved seizure control and discontinued antiepileptic drugs at the last follow-up. Pediatric anti-NMDA receptor autoimmune encephalitis presents with diverse clinical manifestations, and long-term prognosis is generally favorable with early diagnosis and timely treatment.