Pediatric Neuroimmune Brain Disorders

What Are the Types of Neuroimmune Disorders in Children?

Different types of neuroimmune disorders can affect children.

Demyelinating Neuroimmune Disorders

Some neuroimmune disorders cause the immune system to attack and damage a protective covering on nerves called the myelin sheath. This process is called demyelination. Types of demyelinating neuroimmune disorders include:

• Acute disseminated encephalomyelitis (ADEM): This type of encephalitis typically occurs when a viral or bacterial infection triggers inflammation from the immune system. This inflammation damages the myelin sheath that protects nerve cells in the brain and spinal cord. 
• Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD): MOGAD occurs when the immune system attacks nerve fibers in the brain, spinal cord and optic nerves. The optic nerves carry messages between the eyes and brain.
• Neuromyelitis optica (NMO): NMO occurs when the immune system damages nerves in the spinal cord and optic nerves.
• Optic neuritis: Optic neuritis occurs when the immune system damages the myelin sheath that protects the optic nerves.
• Pediatric multiple sclerosis (MS): Pediatric multiple sclerosis occurs when the immune system attacks the myelin sheath that protects nerve cells in different areas of the brain and spinal cord.
• Transverse myelitis: Transverse myelitis occurs when the immune system attacks the myelin sheath that protects nerve cells in the spinal cord.

Nondemyelinating Neuroimmune Disorders

Other types of neuroimmune disorders in children include:

• Autoimmune encephalitis: This condition occurs when the immune system attacks nerve cell proteins or receptors, causing neurological symptoms. 
• Anti-NMDA receptor encephalitis: This type of autoimmune encephalitis occurs when the immune system makes antibodies (proteins) that attack N-methyl-D-aspartate (NMDA) receptors in the brain.
• Central nervous system (CNS) vasculitis: This type of vasculitis causes swelling and damage to blood vessels that carry blood to the brain and spinal cord.  
• Opsoclonus-myoclonus-ataxia syndrome (OMAS): OMAS occurs when a neuroblastoma tumor or viral infection causes the immune system to attack the areas of the brain that control balance and movements. 

What Causes Neuroimmune Disorders in Children?

In many instances, experts aren’t sure what triggers neuroimmune brain disorders in children. The immune system usually fights germs to keep a child healthy. But sometimes, a neurological problem, infection or something else can cause the immune system to overreact. 

In this case, the immune system may respond to substances that aren’t a threat and mistakenly attack healthy parts of the body. This attack can cause inflammation that damages the nervous system.

What Are the Signs and Symptoms of Pediatric Neuroimmune Disorders? 

Signs of neuroimmune disorders in children depend on the specific condition. In general, neuroimmune disorders may cause:

• Balance and coordination issues 
• Behavioral problems or changes, such as aggression 
• Confusion or memory loss
• Hallucinations or psychoses
• Headaches
• Muscle cramps, weakness and/or spasticity
• Nausea and vomiting
• Pee and/or poop accidents
• Seizures
• Speech problems
• Vision loss or other eye problems

How Are Neuroimmune Disorders in Children Diagnosed?

Pediatric neuroimmunologists are pediatric neurologists who specialize in nervous system and immune system interactions. They have advanced training in helping children who have neuroimmune disorders. Pediatric neuroimmune disorders are rare and complex, making them challenging to diagnose. Lurie Children’s doctors perform comprehensive physical exams and tests to make an accurate diagnosis. 

Your child may get one or more of these diagnostic tests:

• Neuroimaging tests, such as brain and spinal cord MRIs, to look for inflammation and swelling
• Blood tests to check for immune markers that indicate autoimmune disease or inflammation
• Electroencephalogram (EEG), including video EEG, to monitor brain activity and seizure
• Lumbar puncture (spinal tap) to check cerebrospinal (brain and spinal cord) fluid for signs of inflammation and infection
• Nerve conduction studies to assess the health and function of peripheral nerves that control voluntary movements and sensations
• Electromyography (EMG) to assess muscle and nerve function
• Neurosurgery (in rare cases) to remove a sample of brain tissue to biopsy for signs of disease
• Visual screenings and eye exams to check for optic nerve damage and vision problems
• Genetic screening to look for gene changes that cause neuroimmune disorders

How Are Pediatric Neuroimmune Brain Disorders Treated?

While there isn’t a cure for pediatric neuroimmune brain disorders, treatments can ease symptoms, so your child can enjoy a full life. Treatment options depend on the type of neuroimmune disorder and your child’s symptoms. Lurie Children’s team creates a personalized treatment plan to address your child’s unique needs.

We offer a full array of neuroimmune disorder treatments, including: 

• Medications, including intravenous immunoglobulin (IVIG), therapeutic plasma exchange (also called plasmapheresis), steroids and immunotherapy, to ease symptoms and slow disease progression 
• Rehabilitative services, such as physical therapy and occupational therapy, to improve balance, mobility and function
• Inpatient rehabilitation at the Shirley Ryan AbilityLab
• Orthotic treatments to support movement and stability
• Speech therapy to address speech impairments and feeding and swallowing problems 
• Clinical nutrition services to aid recovery, including one of the nation’s largest Ketogenic Diet Therapy Programs for children experiencing chronic, treatment-resistant seizures

What Is Lurie Children’s Approach to Caring for Children With Neuroimmune Disorders?

Lurie Children’s Neuroimmunology Clinic brings together an interdisciplinary team of experts to care for children with neuroimmune disorders. U.S. News & World Report ranks Lurie Children’s among the best in the country for pediatric neurology and neurosurgery. 

Our specialized services include:

• Dedicated focus on neuroimmune disorders: At Lurie Children’s Neuroimmunology Clinic, your child sees experts who have deep experience treating these rare, complex disorders. In addition to neuroimmunologists, your child’s care team may include specialists in ophthalmology, infectious diseases, rheumatology, neuropsychiatry and other fields.
• Advanced neuroimaging: Our pediatric neuroradiologists use state-of-the-art neuroimaging technology to get detailed images that aid diagnosis and treatment decisions. 
• Expert nerve and muscle tests: Nerve and muscle tests take place in our Clinical Neurophysiology Laboratory. Our pediatric EMG/NCS lab is accredited with exemplary status. This distinction from the American Association of Neuromuscular and Electrodiagnostic Medicine (AANEM) reflects our commitment to provide testing that meets the highest standards. 
• Comprehensive seizure care: Children with neuroimmune disorders who develop seizures receive care at our nationally recognized Pediatric Epilepsy Center. We have one of the nation’s largest pediatric Ketogenic Diet Therapy Programs, as well as a dedicated Epilepsy Monitoring Unit.
• Child-friendly infusion unit: Our infusion team, including certified Child Life Specialists, knows how to keep kids comfortable as they receive IV treatments in our dedicated pediatric infusion unit. Families have access to private rooms, age-appropriate games and activities, snacks, drinks and more.
• Developmental services: Our Division of Developmental and Behavioral Pediatrics helps families manage learning disabilities and behavioral issues. We offer neuropsychological testing and other services to support your child’s developmental growth.
• Research and clinical trials: Our teams’ involvement in pediatric neurology research and clinical trials means your child may benefit from promising new therapies not widely available elsewhere.

Lurie Children’s Neuroimmunology Clinic 

An interdisciplinary team of specialists at Lurie Children’s Neuroimmunology Clinic provides compassionate care for children with neuroimmune disorders. Your child benefits from the latest therapies and a personalized treatment plan that helps them get the most out of life.

Learn more about our Neuroimmunology Clinic.