Antikörpervermittelte Autoimmunenzephalitiden im Kindes- und Jugendalter

Diseases affecting the central nervous system where the immune system plays a central role have also become increasingly more important in pediatrics in recent years. This is true particularly due to the therapeutic consequences, which are associated with the diagnosis. The diagnosis of many more frequent but also rarer antibody-mediated diseases has been made possible through the development of new techniques, such as cell-based assays (CBA). In the clinical practice two antibody-mediated diseases affecting mainly the gray matter are relevant: N‑methyl-D-aspartate receptor (NMDA-R) encephalitis and myelin oligodendrocyte glycoprotein (MOG) encephalitis. The NMDA‑R encephalitis can present with a typical course but can also have purely psychiatric symptoms or epilepsy, whereas MOG encephalitis is an important differential diagnosis to pathogen-related encephalitis. Apart from antibody-mediated encephalitis, a subgroup of autoantibody-negative but probable autoimmune encephalitis is encountered in the clinical practice, which must fulfil the criteria of Graus et al. in order to minimize false diagnoses and to avoid unnecessary long-term immunomodulatory treatment.