Autoimmune Encephalitis

  • Autoimmune encephalitis
    Rapidly progressing: < than six weeks
  • Memory deficit + mental status change
  • + neuropsychiatric symptoms, behavioral problem autonomic disturbances movement disorder & seizures
  • Some vision loss, weakness, sleep issues, anxiety, psychosis w hallucinations 
  • MRI, EEG, CSF Pleocytosis > 5 WBCs per mm3
  • R/O Metabolic, Infectious, Toxic 
  • Others are Auto-immune &  Paraneoplastic
  • Testing: NMDA receptor antibody, IgG in CSF with reflex to titer is Preferred.
  • CSF auto immune encephalitis panel
  • CSF NMDA receptor antibody, IgG with reflex to titer
  • NMDA receptor Ab, IgG w reflex titer in serum 
  • Serum NMDA receptor antibodies have falls positive
  • Antibodies do not normalize even with therapy
  • Other testing CBC with differential, sed rate, CRP, B12, VIT D, thyroid function test free T3 T4 thyroid antibodies, antithyroglobulin antibodies, anti-thyroid stimulating hormone receptor, serology for infection, serum lactate,ANA, anti-double stranded DNA, anti-smith, serum compliments, immunoglobulin, urine drug screen for opioid, marijuana, cocaine, 
  • CSF: Cell, protein glucose, lactate, Oligoclonal bands, Neopterin
  • Nasopharyngeal swab for mycoplasma, viruses
  • Serum & CSF antibodies for autoimmune encephalitis panel
  • ✅ Corticosteroid, or IVIg, if no consider secondary treatment such as Rituxan (read more)

⭕️ Autoimmune Encephalitis Checklist: for the family to help: • Cognitive issues • Memory loss• Involuntary movements
• Seizures
• Ataxia
• Speech: Slow / loss
• Rapid, pressured or involuntary speech
• Behavioral: psychosis / agitation
• Loss of inhibition
• Hallucinations (visual / auditory)
• Paranoid thoughts
• Severe anxiety
• Sleep disruption / insomnia
• Anorexia• Ageusia triggering nausea
• Polyphagia
• Decreased level of consciousness, unresponsiveness, catatonia or coma
• Weaknes•balance
•numbness • Vision changes

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