FEATURES OF DIFFERENTIAL DIAGNOSIS OF ENCEPHALITIS, ENCEPHALOMYELITIS, AND DISSEMINATED ENCEPHALOMYELITIS IN CHILDREN: CONTEMPORARY CLINICAL, NEUROIMAGING, AND NEUROIMMUNOLOGICAL APPROACHES

Abstract

Background. Encephalitis, encephalomyelitis, and acute disseminated encephalomyelitis represent a heterogeneous spectrum of inflammatory neurological disorders in children. Their clinical manifestations frequently overlap, creating substantial diagnostic challenges, particularly during the early stages of disease. The emergence of autoimmune encephalitis syndromes, myelin oligodendrocyte glycoprotein antibody-associated disease, and improved molecular diagnostic techniques has fundamentally transformed pediatric neuroinflammatory diagnostics.

Materials and Methods. A narrative analytical review of peer-reviewed publications, international diagnostic criteria, observational studies, and consensus recommendations was conducted. Particular attention was paid to clinical phenotyping, magnetic resonance imaging, electroencephalography, cerebrospinal fluid molecular testing, neuronal autoantibodies, and myelin oligodendrocyte glycoprotein antibodies.

Results. Major distinguishing characteristics of infectious, antibody-mediated, and demyelinating inflammatory disorders were systematically evaluated. An original conceptual framework, PED-NEURODIFF, was developed to organize diagnostic decisions through sequential assessment of inflammatory encephalopathy, spinal cord involvement, neuroimaging patterns, etiological biomarkers, and longitudinal disease evolution.

Conclusion. Accurate differentiation of pediatric encephalitis and encephalomyelitis requires an integrated diagnostic approach rather than reliance on individual clinical or laboratory findings. Combining clinical assessment, neuroimaging, electroencephalography, molecular microbiology, and targeted autoantibody testing may facilitate earlier etiological classification, appropriate treatment selection, and long-term neurological surveillance.