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The Diagnosis and Treatment of Autoimmune Encephalitis

autoimmune encephalitis treatment

Autoimmune encephalitis (AE) is a group of autoimmune inflammatory conditions. In autoimmune encephalitis, the immune system mistakenly attacks healthy brain cells. Autoantibodies are produced against neuronal antigens, resulting in multiple neurological and mental problems. Individuals with AE may have a variety of symptoms.

Patients with AE frequently require long-term intensive care due to the severity of their sickness. Depending on the disease, relapses may occur more or less frequently. Conversely, some diseases may be less likely to return if treated promptly and effectively. It is essential to initiate autoimmune encephalitis treatment as soon as the diagnosis is made.

Autoimmune encephalitis (AE) can exhibit in various ways, depending on the individual affected. Some individuals develop new or different symptoms suddenly. A person with AE, for instance, may initially hallucinate before progressing to seizures or memory issues. Early in the disease’s progression, symptoms may fluctuate or alternate between improving and deteriorating.

The present article intends to explore every aspect of autoimmune encephalitis, from types to treatment. So, continue reading to learn about the autoimmune encephalitis diagnosis and treatment.

Types of Autoimmune Encephalitis

Autoimmune encephalitis is characterized by the immune system’s inflammatory attack on the brain induced by the production of antibodies. Similar to multiple sclerosis, the illness may worsen over time. Various types of autoimmune encephalitis are determined by the antibodies present.

The types of autoimmune encephalitis are listed below:

  • Acute disseminated encephalomyelitis (ADEM)
  • Hashimoto’s encephalopathy
  • Anti-NMDAR receptor encephalitis
  • Limbic encephalitis
  • LG11/CASPR2-antibody encephalitis
  • Rasmussen’s encephalitis

If untreated, autoimmune encephalitis can rapidly progress to a more severe form. It could induce loss of consciousness or irreparable brain damage. In extremely rare instances, it could be fatal. So, autoimmune encephalitis treatment must be initiated early.

Symptoms could become apparent between a few days and several weeks. They may depend on the type of autoimmune encephalitis the individual has.

In the early stages of the illness, individuals may experience flu-like symptoms, including headaches, fever, nausea, and aching muscles. Mental health problems can develop, disappear, and then reappear. Later symptoms, such as decreased awareness or possibly coma, could be even worse.

Here are some of the most prevalent symptoms and signs:

  • Memory loss and confusion
  • Twitching or uncontrollable facial expressions
  • Having difficulty speaking and seeing clearly
  • Insomnia
  • A feeling of weakness or numbness
  • Seizures and anxiety attacks
  • Changes in a sexual behavior
  • Hallucinations and irrational thoughts
  • Inability to maintain consciousness

In many cases of autoimmune encephalitis, the source of the ailment is unknown. One of the causes of this condition is a bacterial infection. The streptococcus bacteria and the herpes simplex virus can both cause strep throat and may lead to encephalitis in severe cases.

Another possible causative agent could be teratoma. They are a form of tumor that typically develops in the ovaries of females. They induce the immune system to produce antibodies responsible for inflammation. Certain tumors can trigger an autoimmune response, causing the immune system to destroy the body’s tissues.

Autoimmune Specialist

Autoimmune Encephalitis Diagnosis

The diagnosis of autoimmune encephalitis is notoriously challenging. It is commonly confused with other illnesses, such as substance misuse or mental illness, due to its rarity. On the other hand, obtaining an early diagnosis is essential for avoiding more severe issues.

If you exhibit symptoms of autoimmune encephalitis, your physician will do a neurologic examination to evaluate your reflexes, nerve activity, thinking, and other functions. This test will identify whether or not you have the disease. You may undertake additional testing to rule out the potential of additional conditions.

Diagnostic Tests for Autoimmune Encephalitis

The following tests could be performed:

Spinal Tap

A lumbar puncture or spinal tap is a procedure involving the removal of cerebrospinal fluid, the fluid surrounding the brain and spinal cord. Diagnostic tests can be conducted on the fluid to look for indications of autoimmune encephalitis.

Blood Test 

Testing an individual’s blood for antibodies helps in autoimmune encephalitis diagnosis. Antibodies in the patient’s blood are identified that may indicate the presence of a disorder.

Brain Scanning 

MRI, i.e., Magnetic Resonance Imaging of the brain, shows temporal abnormalities indicative of autoimmune limbic encephalitis.

Autoimmune Encephalitis Treatment

First Line Therapy

Intravenous corticosteroids are utilized as a first-line autoimmune encephalitis treatment. It also includes intravenous immunoglobulin or plasma exchange. The purpose of this mixture is to reduce antibody levels rapidly. If a patient does not respond to the initial immune therapy, stronger medicines with a higher risk of side effects are typically administered. Among the available treatments include cyclophosphamide and rituximab. Relapses can occur when a patient’s immune therapy is reduced, cancer returns or a missed malignancy is still there.

Second Line Therapy

When first-line autoimmune encephalitis treatment fails, switching to second-line autoimmune encephalitis treatment is required. It is associated with a better outcome and a reduced relapse rate, especially for patients who have previously received the first treatment. Patients with ovarian teratoma whose tumors are surgically removed have a greater probability of making a full recovery and a reduced risk of the malignancy returning.

The initial autoimmune encephalitis treatment for LGI1 encephalitis is effective, and the patient’s prognosis is favorable. Long-lasting cognitive issues, on the other hand, are relatively prevalent with corticosteroid treatment.

Extensive Care Need

Patients with autoimmune encephalitis may require extensive care to feel better. Autoimmune encephalitis treatment may include lengthy stays in the intensive care unit. It may be necessary to treat conditions such as agitation and seizures, systemic disorders, and infections. Antipsychotic medications may be required, but they must be cautiously administered due to the risk of extrapyramidal side effects. There is an associated risk of neuroleptic malignant syndrome as well. These risks are more prevalent in NMDA-R encephalitis.

Modest neurocognitive and psychosocial disorders are prevalent during the recovery phase. It is also essential to seek assistance from mental health professionals and counseling services during autoimmune encephalitis treatment.

See Also: Autoimmune Hemolytic Anemia: Treatment, Symptoms & Types

Conclusion

Autoimmune encephalitis can result in a variety of significant long-term clinical outcomes that can alter an individual’s quality of life. Neurocognitive symptoms impacting an individual’s life include lack of concentration, memory problems, mood disorders, difficulty sleeping, seizures, and fatigue. So, a multidisciplinary approach is crucial as it assists patients with these consequences. Occupational therapy, speech therapy, neuropsychology, and psychology consultations are necessary for autoimmune encephalitis treatment.

Autoimmune specialists at Family Medicine Austin offer the best quality care for diseases like autoimmune encephalitis. With our advanced diagnostic and screening services, it is possible to diagnose the condition to initiate early treatment precisely. So, book your consultation with us now.

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Written by Jeannette

I am Jeannette, the medical writing specialist here at Family Medicine Austin. I have over five years of experience working with a range of medical and healthcare across the U.S.