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Autoimmune Encephalitis – Causes, Symptoms, Diagnosis, Treatment

Dr. Harun Ar Rashid, MD - Arthritis, Bones, Joints Pain, Trauma, and Internal Medicine Specialist Dr. Harun Ar Rashid, MD - Arthritis, Bones, Joints Pain, Trauma, and Internal Medicine Specialist
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Rx Autoimmune, Genetic and Rare Diseases (A - Z)
Autoimmune encephalitis refers to a group of conditions that occur when the body’s immune system mistakenly attacks healthy brain cells, leading to inflammation of the brain. People with autoimmune encephalitis may have various neurologic and/or psychiatric symptoms. Neurologic symptoms may include impaired memory and cognition, abnormal movements, seizures, and/or problems with balance, speech, or vision.[1][2] Psychiatric symptoms may include psychosis, aggression, inappropriate sexual behaviors, panic attacks, compulsive behaviors, euphoria or fear. Symptoms may fluctuate but often progress over days to a few weeks. Symptoms can progress to loss of consciousness or even coma.[1]

Autoimmune encephalitis may be associated with antibodies to proteins on the surface of nerve cells, or within nerve cells. Some of these proteins are involved in passing signals between nerve cells.[1][3][4] In some cases, it occurs in association with cancer (a paraneoplastic syndrome).[3][1] Research regarding why specific antibodies attack the body’s healthy cells is ongoing. Autoimmune encephalitis generally occurs sporadically, in people with no family history of the condition.[2]

Treatment may involve intravenous immunosuppressive therapy and tumor removal when necessary. Early treatment decreases the likelihood for long-term complications, speeds recovery, and reduces the risk of recurrence (relapse). If not treated, the condition can lead to progressive neurologic deterioration and loss of life.[3]

Diagnosis of autoimmune encephalitis can be made when all three of the following criteria have been met:[4]

1. Subacute onset (rapid progression of less than 3 months) of working memory deficits (short-term memory loss), altered mental status, or psychiatric symptoms

2. At least one of the following:

• New focal CNS findings
• Seizures not explained by a previously known seizure disorder
• CSF pleocytosis (white blood cell count of more than five cells per mm3)
• MRI features suggestive of encephalitis

3. Reasonable exclusion of alternative causes

References

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