The diagnosis and treatment of AE is often delayed due to symptoms that overlap with other diagnoses including infectious encephalitis. Outcomes are best if treatment is started within the first month of symptom onset. Clinical criteria (Graus et al 2016) have been published to aid in earlier recognition of AE, and more recently, consensus criteria for pediatric AE (Cellucci et al 2020) were proposed. However, the predictive value of these criteria in the early stages of the disease have not yet been evaluated.

A retrospective chart review of patients presenting to Children’s Hospital Colorado with suspicion for encephalitis over the past 11 years was performed. Patients ≤ 18 years of age with a final diagnosis of antibody-positive or antibody-negative AE, or etiology-confirmed viral encephalitis were included in analysis. PPV and NPV were calculated for each set of clinical criteria for possible AE at multiple time points (1, 2, and 4 weeks after initial onset of neuropsych symptoms).

The early initiation of immunotherapies in AE is important to improve clinical outcomes and decrease hospital stays. This requires a reliable method for the early diagnosis of AE.  Our data evaluating the accuracy of the 2020 consensus criteria for pediatric AE early in the disease process will help clinicians and researchers better understand the role of these criteria in clinical practice for children presenting with suspicion for encephalitis.