Autoimmune Encephalitis

What is autoimmune encephalitis?

Autoimmune encephalitis is the term used to describe a broadening group of autoimmune inflammatory diseases that primarily affect the grey matter of the central nervous system. This includes the limbic system, neocortex, basal ganglia, cerebellum and brain stem.

Read more …

How does this pathological process appear to unfold?

The majority of patients with autoimmune encephalitis test positive for autoantibodies against nerve cell components. These antibodies are typically found in the cerebrospinal fluid (CSF) and blood serum and can be detected using modern assay methods (Diagnostics).

Read more …

How do we diagnose autoimmune encephalitides?

The clinical suspicion of autoimmune encephalitis is usually founded on the acute or subacute onset and rapid progression (<3 months) of short-term and working memory deficits, on a qualitative and quantitative impairment of consciousness or on the subacute onset of psychiatric symptoms reflected as personality changes, behavioral anomalies and affective disorders (Graus 2016).

Read more …

How are neuronal antibodies detected?

In recent years, the testing options for antineuronal antibodies have grown in both quantity and complexity. Like every test system, the assays employed can produce both false-positive and false-negative findings. A number of measures, however, can minimize these drawbacks. Performed correctly, the detection of antineuronal antibodies facilitates differential diagnostics, enables a more accurate prognosis, defines the recommended therapy and informs the search for tumors.

Read more …

When and how is it appropriate to search for an underlying tumor?

In seropositive autoimmune encephalitides, the probability and most common localization of an underlying tumor can be predicted regardless of the detected neuronal antibody. Of course, risk factors (e.g. smoking history), age and gender should also be taken into account in these considerations. Tumor diagnostics should be graded.

Read more …

How do we treat autoimmune encephalitis?

At present, there are no prospective clinical trials, but only good retrospective therapeutic data on anti-NMDAR encephalitis. Therefore, the therapy of the autoimmune types of encephalitides is oriented on the therapy established for anti-NMDAR encephalitis.

Read more …

Centers

Find a center near you here.

Latest news

Upcoming events

Currently there are no events.

References

Peer M, Prüss H, Ben-Dayan I, Paul F, Arzy S, Finke C.
Lancet Psychiatry. 2017 Oct;4(10):768-774. doi: 10.1016/S2215-0366(17)30330-9. Epub 2017 Sep 4.
PMID: 28882707
Link: https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(17)30330-9/fulltext

Heine J, Prüss H, Kopp UA, Wegner F, Then Bergh F, Münte T, Wandinger KP, Paul F, Bartsch T, Finke C.
J Neurol Neurosurg Psychiatry. 2018 Nov;89(11):1191-1199. doi: 10.1136/jnnp-2017-317780. Epub 2018 Jun 9.
PMID: 29886429
Link: https://jnnp.bmj.com/content/89/11/1191

Autoantibody-mediated encephalitis - differential diagnosis in patients with impaired consciousness of unclear origin

Wandinger, Klaus-Peter; Leypoldt, Frank; Junker, Ralf
Dtsch Arztebl Int 2018; 115(40): 666-73; DOI: 10.3238/arztebl.2018.0666
Link: https://www.aerzteblatt.de/archiv/201062/Autoantikoerper-vermittelte-Enzephalitiden

Dalmau J, Graus F.
N Engl J Med. 2018 Mar 1;378(9):840-851. doi: 10.1056/NEJMra1708712. Review. No abstract available.
PMID: 29490181
Link: https://www.nejm.org/doi/full/10.1056/NEJMra1708712

Mueller SH, Färber A, Prüss H, Melzer N, Golombeck KS, Kümpfel T, Thaler F, Elisak M, Lewerenz J, Kaufmann M, Sühs KW, Ringelstein M, Kellinghaus C, Bien CG, Kraft A, Zettl UK, Ehrlich S, Handreka R, Rostásy K, Then Bergh F, Faiss JH, Lieb W, Franke A, Kuhlenbäumer G, Wandinger KP, LeypoldtF; German Network for Research on Autoimmune Encephalitis (GENERATE).
Ann Neurol. 2018 Apr;83(4):863-869. doi: 10.1002/ana.25216.
Link: https://onlinelibrary.wiley.com/doi/abs/10.1002/ana.25216

Malviya M, Barman S, Golombeck KS, Planagumà J, Mannara F, Strutz-Seebohm N, Wrzos C, Demir F, Baksmeier C, Steckel J, Falk KK, Gross CC, Kovac S, Bönte K, Johnen A, Wandinger KP, Martín-García E, Becker AJ, Elger CE, Klöcker N, Wiendl H, Meuth SG, Hartung HP, Seebohm G, Leypoldt F, Maldonado R, Stadelmann C, Dalmau J, Melzer N, Goebels N.
Ann Clin Transl Neurol. 2017 Oct 3;4(11):768-783. doi: 10.1002/acn3.444. eCollection 2017 Nov.
PMID: 29159189
Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5682115/