Autoimmune Encephalitis

Autoimmune Encephalitis

Overview

Autoimmune encephalitis is a condition in which the body’s immune system attacks healthy tissue in the brain or spinal cord. It is a rare, dangerous disease that can cause serious physiological and psychological damage. Patients may experience neurological symptoms like seizures and memory problems. In addition to this, they may also experience psychological symptoms like psychosis, panic attacks and excessive aggression. Autoimmune encephalitis is associated with the production of antibodies to the protein on nerve cells. In some cases, it may be associated with a cancerous tumour. There are different types of autoimmune encephalitis including acute disseminated encephalomyelitis (ADEM), Hashimoto’s encephalopathy, limbic encephalitis and Rasmussen’s encephalitis. Autoimmune encephalitis does not appear to have a relationship with patient family history.

Signs and symptoms

Patients with autoimmune encephalitis experience neurological and psychological symptoms that may include impaired memory, slurred speech, abnormal movement, poor muscle co-ordination, problems with balance and impaired vision. The patient may also have psychological symptoms like psychosis, aggression, panic attacks, excessive euphoria and fear as well.

Causes

The exact cause of autoimmune encephalitis is unknown but it appears related to the production of antibodies that target proteins on the nerve cells. The body may begin producing these antibodies as a result of an auto-immune disease, a teratoma (tumour), or cancer.

Risk factors

Patients with multiple sclerosis seem to be at an increased risk of developing autoimmune encephalitis.

Complications

Patients with autoimmune encephalitis could develop long-term neurological deficits and permanent psychological changes.

Diagnosis

The diagnosis of autoimmune encephalitis is made by a multidisciplinary team of rheumatologists, neurologists and psychologists. The diagnosis requires a thorough physical and neurological exam and a detailed medical history. The physicians will also require detailed imaging tests such as MRI and CT scans. A spinal tap may be done to check the cerebrospinal fluid for antibodies. An abdominal ultrasound may also be performed to check for tumours.

Treatment

Early diagnosis and treatment can reduce chances of permanent neurological deficits. The patient may be treated with steroids to reduce brain inflammation. If the condition is triggered by a teratoma, the doctor may recommend surgical removal of the tumour. The doctor may also treat the patient with plasma exchange therapy or intravenous immunoglobulin therapy. If these treatments do not work, as a last resort, the doctor may suggest immunosuppressant medication. Once the encephalitis is under control, the patient may be recommended physical therapy, speech therapy or occupational therapy.

Prevention

As the cause of autoimmune encephalitis is not known, there are no specific preventive strategies in place.

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