eanCast: Weekly Neurology Ep. 133: Autoimmune encephalitis
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Feb 2, 2025 Alberto Vogrig, an assistant professor from the University of Udine, and Maarten Titulaer, an associate professor at Erasmus University Medical Center, dive into autoimmune encephalitis. They discuss the complexities of diagnosing this condition, emphasizing the urgent need for early recognition and effective treatment. The conversation highlights the role of advanced imaging and antibody testing, the challenges of underdiagnosis, and the exciting potential for new biomarkers, underscoring the importance of tailored management in patient care.
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Suspecting Autoimmune Encephalitis
- Consider autoimmune encephalitis if symptoms onset within days to three months.
- Look for memory, behavioral changes, seizures, ataxia, but be aware that symptoms vary depending on the affected brain area.
Common Antibody Syndromes
- NMDA receptor and LGI1 encephalitis are the two most common antibody-mediated syndromes.
- LGI1 typically affects patients over 50, while NMDA has a median age of 21 but can also occur in older adults.
Paraclinical Studies for Autoimmune Encephalitis
- Perform brain MRI, EEG, and CSF analysis in suspected cases.
- These tests may not always be definitive, especially CSF in anti-LGI1 or -CASPR2 encephalitis.