Autoimmune Brain Diseases
Autoimmune brain diseases, including autoimmune encephalitis and CNS vasculitis, can cause rapid changes in the physical and mental health of your child. Because the symptoms can be so diverse, diagnosis can be challenging and is often delayed. Early diagnosis and treatment are critical to minimizing the short- and long-term impacts of these disorders, as many of the symptoms may be reversible. Duke specialists are committed to diagnosing these diseases early and beginning treatment rapidly, to minimize symptoms and maximize your child’s recovery.
Understanding Autoimmune Brain Disease
Autoimmune brain diseases occur when the body’s immune system attacks healthy cells and tissues in the brain or spinal cord, which results in inflammation. This inflammation may then cause impaired functioning, resulting in neurological or psychiatric symptoms.
Children affected by these disorders can develop many symptoms, including a decline in school performance, seizures, abnormal movements, vision loss, weakness of arms or legs, loss of language, and sleep problems. Psychiatric symptoms may include severe depression and hallucinations, as well as paranoid, obsessive, or erratic behavior.
There are several types of autoimmune brain diseases. Diagnosing which one your child has is often the first step. Autoimmune brain diseases include:
- Autoimmune encephalitis
- Autoimmune-related epilepsy
- Central nervous system vasculitis
- Hashimoto’s encephalopathy (steroid-responsive encephalopathy)
- Neuromyelitis optica
- Optic neuritis
- Neurosarcoidosis
- Neuro-Behcet’s disease
- Cerebral lupus
Duke’s pediatric autoimmune brain diseases program is dedicated to the treatment of these rare, complex diseases. Our specialists provide rapid, effective treatment and can help your child manage the full spectrum of symptoms caused by these diseases.
- A team approach to your child’s care. Our comprehensive team approach can greatly improve your child’s opportunity for recovery. Our team includes doctors, clinical coordinators, skilled nurses, psychologists, and social workers. Our experts are well known in their respective fields and include specialists in pediatric neurology/epilepsy, rheumatology, psychology, psychiatry, allergy and immunology, and neuro-ophthalmology. We communicate regularly with each other about your child’s care, treatment, and progress.
- Your convenience is important to us. Your child will benefit from seeing the specialists involved in her care on the same day. They meet in the same room, at the same time, with you and your child to understand her history and symptoms as well as discuss her evaluation and treatment plan. This approach allows for improved communication among team members, our patients, and their families. Our care coordinator helps your family schedule visits and diagnostic testing.
- Your child’s safety is our main concern. Children and adolescents with autoimmune brain diseases may experience psychiatric symptoms, some of which can jeopardize their safety. Our child psychiatrist can assess your child’s potentially altered behavioral health and prescribe medication, if needed, to keep him or her safe and comfortable.
Nationally Recognized Autoimmune Brain Disease Specialists
Our focus and expertise in the study and management of autoimmune brain diseases in children is well known. Nearly half of our patients travel to Duke from outside our local region. They are referred to us because of the depth of care we provide.
- We help set national guidelines. Our pediatric rheumatologist and pediatric neurologist are active with national organizations and help develop guidelines for the diagnosis and treatment of autoimmune encephalitis.
- We maintain an active research program. We are constantly conducting research to better understand how autoimmune brain diseases develop, in hopes of identifying better ways to diagnose and treat them.
AUTOIMMUNE BRAIN DISORDERS
Diagnosis and Treatment
The study and treatment of autoimmune brain diseases is a relatively new field. Unfortunately, this may lead to misdiagnosis, as symptoms can often mimic many other disorders. In addition, the range of symptoms can vary greatly from child to child, both in types of symptoms and their severity. A comprehensive evaluation, tests, and ongoing treatment can reduce inflammation, minimize brain injury, and maximize your child’s ability to function.
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During your child’s first visit, we perform a full evaluation that includes a thorough history, a complete physical examination, blood tests, and imaging studies. This information allows us to make an accurate diagnosis and tailor our treatment recommendations.
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Treatments for pediatric autoimmune brain diseases vary depending on the specific disease your child has and the type and severity of their symptoms. To maximize your child’s ability to function and minimize suffering, it is essential to treat both the underlying inflammation as well as the symptoms. Treatments may include medications that suppress the immune system to decrease inflammation, as well as treatments to reduce seizures, psychiatric symptoms, and sleep disturbances. We often use a combination of therapies to achieve the best possible immediate and long-term outcomes for your child.
AUTOIMMUNE BRAIN DISORDERS
Family and Support Services
We provide family-friendly services to support you and your entire family. We are here to answer your questions and make your time at Duke Children’s as easy and comfortable as possible.
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Whether it's explaining a procedure or offering encouragement and emotional support, you and your child get care in a warm, welcoming environment. We’re here to help you as your child goes through treatment and recovery.
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It’s helpful to have a team on your side to assist you in managing your child’s care. Our care coordinators and social workers help you navigate the medical system and coordinate the variety of health services your child needs, including appointments for testing, treatment, and other medical care. They can help you work with insurance providers, connect you with resources, and help you manage the details related to your child’s care. They’re also connected to services that assist out-of-town families, including travel.