Abstract:

Objective To explore clinical features of double-positive autoimmune encephalitis of children's anti-myelin oligodendrocyte glycoprotein (MOG) antibodies complicated with anti-N-methyl-D-aspartate receptor (NMDAR) antibodies. Methods The case data of 2 children with anti-MOG antibodies combined with anti-NMDAR antibody double-positive autoimmune encephalitis admitted to Handan Central Hospital were retrospectively analyzed, and the relevant literature was reviewed. Results The number of leukocytes in cerebrospinal fluid increased in 2 cases, both supratentorial and infratentorial lesions were found in the head magnetic resonance imaging (MRI) of one case, one case was found to have supratentorial lesions only, and the video electroencephalogram outcome was similar to that of anti-NMDAR encephalitis. The symptoms of both two cases were improved after being treated with methylprednisolone and human immunoglobulin, and no recurrence was found with either case after 3 months of follow-up. Conclusion The disease is more common in adolescents, both encephalopathic manifestations of anti-MOG antibody-related diseases and anti-NMDAR encephalitis are noted, and the manifestations of anti-NMDAR encephalitis are also noted. Noninvasive examinations including cranial MRI and video electroencephalogram show certain indications, and neuroantibody examination becomes necessary for confirmation. The first-line therapies involve the hormone, immunoglobulin and plasma exchange. Most children respond well to the above therapies, while the pathogenesis remains further study.

Key words: encephalitis, anti-N-methyl-D-aspartate receptor encephalitis, anti-myelin oligodendrocyte glycoprotein antibodies, children