Diagnostic and therapeutic difficulties of pediatric encephalitis with a N Methyl D Aspartate in Libreville: about three cases.

Anti-NMDAR antibody encephalitis is an autoimmune neurological disease, which is defined as an inflammation of the brain due to antibodies attached to N-Methyl-D-Aspartate receptors. This is the most common autoimmune encephalitis and a neurological emergency. It accounts for 4% of all encephalitis cases, making it the fifth most common cause after herpes simplex virus and varicella-zoster virus (VZV) infections. It is rare in pediatrics, with an incidence ranging from 0.07 to 0.085 per 100,000 children in Europe, but in Africa it remains underdiagnosed due to the very high cost of antibody testing in cerebrospinal fluid (CSF) and treatment. It is characterized by neuropsychiatric symptoms and leads to serious cognitive and psychomotor sequelae if left untreated. Therefore, we share our experience with three pediatric cases to clarify the circumstances of their onset, the various clinical signs, and finally, to highlight the diagnostic and management difficulties we encountered in our setting.