Pediatric Autoimmune Encephalitis: A case report of three Zambian children

Autoimmune processes are a common cause of acute encephalitis in both children and adults. Autoimmune encephalitis (AE) is caused by a pathological immune response against neuronal autoantigens. It is a treatable and under-reported condition in sub-Saharan Africa. Attributable factors include low index of suspicion among clinicians, few neurologists and limited access to diagnostic testing for autoimmune antibodies. The complexity of dynamic childhood behaviour and overlapping clinical syndromes associated with brain inflammation make the diagnosis even more challenging to identify in the pediatric population. Clinicians must have a high index of suspicion of AE when a previously healthy child present with new onset symptoms of acute encephalitis unresponsive to antimicrobials, with associated abnormal behaviours, seizures, movement disorders and sleep disturbance with symptoms involving over 3 months of duration. Increased awareness among healthcare personnel and accessibility to diagnostic tools are warranted in resource-limited regions to facilitate early diagnosis and intervention of probable cases.