Approach to Infection-triggered Encephalopathy Syndromes (ITES)

Topic: Approach to Infection-triggered Encephalopathy Syndromes (ITES)

Talk by: Dr. Juhi Gupta (Case Presenter): Assistant Professor (Pediatric Neurology), SMS Medical College, Jaipur, India; Dr. Naveen Sankhyan (Panelist): Professor, Head of Pediatric Neurology, Advanced Pediatrics Centre, PGIMER, Chandigarh, India; Dr. Terrence Thomas (Panelist): Head ＆ Senior Consultant Neurology Service KK Women's and Children's Hospital, Singapore; Dr. Velda X. Han (Expert Faculty): Consultant, Division of Paediatric Neurology, Department of Paediatrics, Khoo Teck Puat - National University Children's Medical Institute, National University Hospital, Singapore

Dr Terrence Thomas is the Head of Neurology Service at KK Women’s and Children’s Hospital in Singapore. He has held a strong focus to medical education and medical Informatics. He enjoys clinical and research work in Neuroimmunology, and thinks there is a story to tell about the unique spectrum of immune-related neurological disorders amongst children living in South East Asia.

Dr. Naveen Sankhyan graduated from IGMC, Shimla and finished his DM training at AIIMS, New Delhi. He joined the Postgraduate Institute of Medical Education and Research at Chandigarh India in 2011. He is currently heading the Pediatric Neurology Services at the institute. He is a member of AOCN and ICNA. His areas of interest are Neuroimmunology and Tropical diseases.
Dr Juhi Gupta trained in India and completed her DM in pediatric Neurology from AIIMS, New Delhi (India). She is currently working as an Assistant Professor (Pediatric Neurology) in the department of pediatrics, SMS Medical college, Jaipur, India. She is the chair of the current FLICNA committee since October 2022. She has over 25 publications in international and national indexed journals. Her clinical interests are epilepsy, stroke, headache and neuro-modulation.

Dr Velda X. Han is a Paediatric Neurologist at the Khoo Teck Puat - National University Children's Medical Institute, National University Hospital, and clinical assistant Professor at the Department of Paediatrics, National University Singapore. She completed her PhD at University of Sydney under the clinical neuroimmunology group. She is passionate about the research and treatment of childhood neuroinflammatory disorders.

About the topic:
Infection-triggered encephalopathy syndromes (ITES) is a CNS syndrome induced by infection or fever, and distinct from either infectious or autoimmune encephalitis. ITES is still underrecognized globally and may be misdiagnosed as viral encephalitis, acute disseminated encephalomyelitis, or seronegative autoimmune encephalitis. Five specific ITESs that have been identified are- acute encephalopathy with biphasic seizures and late reduced diffusion (AESD); acute necrotizing encephalopathy (ANE); mild encephalopathy with a reversible splenial lesion (MERS); acute fulminant cerebral oedema (AFCE); and acute shock with encephalopathy and multiorgan failure (ASEM). The diagnosis of ITES is entirely based on clinical and imaging features, and exclusion of other diseases. To date, no evidence-based therapy for ITES is known. The presence of hyperinflammation provides a rationale for immune-directed therapies.

Learning objectives:

1. To understand the pathophysiology and pattern recognition in children with infection-triggered encephalopathy syndromes (ITES)
2. To understand the management options and recent advances in therapeutics of in infection-triggered encephalopathy syndromes (ITES)