Proportion and spectrum of movement disorders in adolescent and adult patients of autoimmune encephalitis of non-neoplastic aetiology

2019 ◽  
Vol 59 ◽  
pp. 185-189 ◽  
Author(s):  
Deepa Dash ◽  
Kavish Ihtisham ◽  
Madhavi Tripathi ◽  
Manjari Tripathi
2018 ◽  
Vol 76 (1) ◽  
pp. 41-49 ◽  
Author(s):  
Lívia Almeida Dutra ◽  
Fabiano Abrantes ◽  
Fabio Fieni Toso ◽  
José Luiz Pedroso ◽  
Orlando Graziani Povoas Barsottini ◽  
...  

ABSTRACT Autoimmune encephalitis (AIE) is one of the most common causes of noninfectious encephalitis. It can be triggered by tumors, infections, or it may be cryptogenic. The neurological manifestations can be either acute or subacute and usually develop within six weeks. There are a variety of clinical manifestations including behavioral and psychiatric symptoms, autonomic disturbances, movement disorders, and seizures. We reviewed common forms of AIE and discuss their diagnostic approach and treatment.


Author(s):  
Paolo Manganotti ◽  
Giovanni Furlanis ◽  
Miloš Ajčević ◽  
Cristina Moras ◽  
Lucia Bonzi ◽  
...  

AbstractNeurological manifestations may be common in COVID-19 patients. They may include several syndromes, such as a suggested autoimmune abnormal response, which may result in encephalitis and new-onset refractory status epilepticus (NORSE). Quickly recognizing such cases and starting the most appropriate therapy is mandatory due to the related rapid worsening and bad outcomes. This case series describes two adult patients admitted to the university hospital and positive to novel coronavirus 2019 (SARS-CoV-2) infection who developed drug-resistant status epilepticus. Both patients underwent early electroencephalography (EEG) assessment, which showed a pathological EEG pattern characterized by general slowing, rhythmic activity and continuous epileptic paroxysmal activity. A suspected autoimmune etiology, potentially triggered by SARS-CoV-2 infection, encouraged a rapid work-up for a possible autoimmune encephalitis diagnosis. Therapeutic approach included the administration of 0.4 g/kg intravenous immunoglobulin, which resulted in a complete resolution of seizures after 5 and after 10 days, respectively, without adverse effects and followed by a normalization of the EEG patterns.


Author(s):  
Tolga D. Dittrich ◽  
Sira M. Baumann ◽  
Saskia Semmlack ◽  
Gian Marco De Marchis ◽  
Sabina Hunziker ◽  
...  

Abstract Background We investigate the frequency and diagnostic yield of cerebrospinal fluid (CSF) analysis in adult patients with status epilepticus (SE) and its impact on the outcome. Methods From 2011 to 2018, adult patients treated at the University Hospital Basel were included. Primary outcomes were defined as the frequency of lumbar puncture and results from chemical, cellular, and microbiologic CSF analyses. Secondary outcomes were differences between patients receiving and not receiving lumbar puncture in the context of SE. Results In 18% of 408 patients, a lumbar puncture was performed. Of those, infectious pathogens were identified in 21% with 15% detected ± 24 h around SE diagnosis. 74% of CSF analyses revealed abnormal chemical or cellular components without infectious pathogens. Screening for autoimmune diseases was only performed in 22%. In 8%, no or late (i.e., > 24 after SE diagnosis) lumbar puncture was performed despite persistent unknown SE etiology in all, transformation into refractory SE in 78%, and no recovery to premorbid neurologic function in 66%. Withholding lumbar puncture was associated with no return to premorbid neurologic function during hospital stay independent of potential confounders. Not receiving a lumbar puncture was associated with presumed known etiology and signs of systemic infectious complications. Conclusions Withholding lumbar puncture in SE patients is associated with increased odds for no return to premorbid neurologic function, and CSF analyses in SE detect infectious pathogens frequently. These results and pathologic chemical and cellular CSF findings in the absence of infections call for rigorous screening to confirm or exclude infectious or autoimmune encephalitis in this context which should not be withheld.


Author(s):  
Monika Figura ◽  
Maciej Geremek ◽  
Łukasz Milanowski ◽  
Izabela Meisner-Kramarz ◽  
Karolina Duszyńska-Wąs ◽  
...  

2021 ◽  
pp. 1-5
Author(s):  
Anjali Chouksey ◽  
Sanjay Pandey

Autoimmune encephalitis (AIE) constitutes an important treatable cause of movement disorders. We aimed to highlight the spectrum of movement disorder and other salient features of AIE patients diagnosed at our tertiary care centre and describe their clinical symptoms, diagnostic approach, treatment, and outcome. We evaluated 11 patients who presented with movement disorder in association with AIE at our centre. Various abnormal movements observed were tremor, dyskinesias, stereotypy, dystonia, ataxia, asterixis, myoclonus, and parkinsonism. Antibodies were detected against NMDAR (n = 3), LGI-1 (n = 2), GAD-65 (n = 1), CASPR-2 (n = 1), Sox-1 (n = 1), Yo (n = 1), and thyroid peroxidase (n = 1). One patient was diagnosed with opsoclonus myoclonus syndrome associated with the suspected neuroblastic tumour. Six patients responded well to first-line immunotherapy (intravenous immunoglobulins or steroid or both). Three patients with anti-NMDAR antibodies received second-line therapy consisting of rituximab. Movement disorder is one of the most consistent features of AIE. Understanding of the ever-expanding spectrum of antibodies associated with movement disorders helps in the early diagnosis and better management of patients of autoimmune movement disorder.


2020 ◽  
Vol 26 (13) ◽  
pp. 1618-1626
Author(s):  
Andrew McKeon ◽  
Anastasia Zekeridou

Traditionally, multiple sclerosis (MS) specialists have been the go-to providers for managing certain treatable non-demyelinating inflammatory or autoimmune central nervous system (CNS) disorders. The advent of increased incidence (mostly due to improved recognition) prompts the question: who should be managing autoimmune encephalitis? These patients are generally first encountered in the hospital, as well as general neurology and subspecialty clinics, such as epilepsy. Autoimmune neurology is a specialty which gives focus to evaluation and treatment of patients with autoimmune encephalitis, among other disorders, and trains neurologists accordingly. Some of those experts are dual trained in both MS and non-MS inflammatory/autoimmune CNS disorders. Many other autoimmune specialists are trained in non-MS care, such as hospital neurology, movement disorders, and epilepsy. General and other subspecialty providers increasingly find the need to be versed in management of autoimmune encephalitis.


2013 ◽  
Vol 28 (6) ◽  
pp. 804-810 ◽  
Author(s):  
Ignacio Rubio-Agusti ◽  
Miryam Carecchio ◽  
Kailash P. Bhatia ◽  
Maja Kojovic ◽  
Isabel Parees ◽  
...  

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