Autoimmune encephalitis : Part 1 (Epidemiology, Pathophysiology and Clinical spectrum)
Since the identification of anti-N-methyl-D-aspartate (NMDA) receptor antibodies about 15 years ago, many patients with rapidly progressing psychiatric symptoms, abnormal movements, seizures or unexplained coma, have been diagnosed with autoimmune encephalitis (AE). The symptom onset is often unspe...
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| Format: | Article |
| Language: | English |
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South African Medical Association
2023-03-01
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| Series: | South African Medical Journal |
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| Online Access: | https://samajournals.co.za/index.php/samj/article/view/780 |
| _version_ | 1827361376038813696 |
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| author | Juliane Hiesgen Clara Schutte |
| author_facet | Juliane Hiesgen Clara Schutte |
| author_sort | Juliane Hiesgen |
| collection | DOAJ |
| description |
Since the identification of anti-N-methyl-D-aspartate (NMDA) receptor antibodies about 15 years ago, many patients with rapidly progressing psychiatric symptoms, abnormal movements, seizures or unexplained coma, have been diagnosed with autoimmune encephalitis (AE). The symptom onset is often unspecific and might mimic psychiatric disease, but the later course is frequently characterized by severe disease, often requiring intensive care. Clinical and immunological criteria are helpful in identifying the patients, but no biomarkers exist to guide the clinician in therapy or predict outcome. While persons of all ages can be affected by AE, some types of AE affect more children and young adults and are more prevalent in women. This review will focus on encephalitides associated with neuronal cell-surface or synaptic antibodies, which can result in characteristic syndromes, and are often recognizable on clinical grounds. AE subtypes associated with antibodies against extracellular epitopes can occur with or without tumours. Because the antibodies bind and alter the function of the antigen, the effects are often reversible if immunotherapy is initiated, and the prognosis is favourable in most instances. The first part of this series will introduce the topic, provide an overview of current neuronal surface antibodies and how they present, describe the most common subtype, anti-NMDA receptor encephalitis, and discuss the difficulties in recognizing patients with underlying AE amongst patients with new onset psychiatric disorders.
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| first_indexed | 2024-03-08T07:03:16Z |
| format | Article |
| id | doaj.art-f493a08fd6e84bf48790de04b5df4c21 |
| institution | Directory Open Access Journal |
| issn | 0256-9574 2078-5135 |
| language | English |
| last_indexed | 2024-03-08T07:03:16Z |
| publishDate | 2023-03-01 |
| publisher | South African Medical Association |
| record_format | Article |
| series | South African Medical Journal |
| spelling | doaj.art-f493a08fd6e84bf48790de04b5df4c212024-02-03T05:36:05ZengSouth African Medical AssociationSouth African Medical Journal0256-95742078-51352023-03-01113310.7196/SAMJ.2023.v113i3.780 Autoimmune encephalitis : Part 1 (Epidemiology, Pathophysiology and Clinical spectrum) Juliane Hiesgen0Clara Schutte1University of PretoriaUniversity of Pretoria Since the identification of anti-N-methyl-D-aspartate (NMDA) receptor antibodies about 15 years ago, many patients with rapidly progressing psychiatric symptoms, abnormal movements, seizures or unexplained coma, have been diagnosed with autoimmune encephalitis (AE). The symptom onset is often unspecific and might mimic psychiatric disease, but the later course is frequently characterized by severe disease, often requiring intensive care. Clinical and immunological criteria are helpful in identifying the patients, but no biomarkers exist to guide the clinician in therapy or predict outcome. While persons of all ages can be affected by AE, some types of AE affect more children and young adults and are more prevalent in women. This review will focus on encephalitides associated with neuronal cell-surface or synaptic antibodies, which can result in characteristic syndromes, and are often recognizable on clinical grounds. AE subtypes associated with antibodies against extracellular epitopes can occur with or without tumours. Because the antibodies bind and alter the function of the antigen, the effects are often reversible if immunotherapy is initiated, and the prognosis is favourable in most instances. The first part of this series will introduce the topic, provide an overview of current neuronal surface antibodies and how they present, describe the most common subtype, anti-NMDA receptor encephalitis, and discuss the difficulties in recognizing patients with underlying AE amongst patients with new onset psychiatric disorders. https://samajournals.co.za/index.php/samj/article/view/780autoimmune encephalitis |
| spellingShingle | Juliane Hiesgen Clara Schutte Autoimmune encephalitis : Part 1 (Epidemiology, Pathophysiology and Clinical spectrum) South African Medical Journal autoimmune encephalitis |
| title | Autoimmune encephalitis : Part 1 (Epidemiology, Pathophysiology and Clinical spectrum) |
| title_full | Autoimmune encephalitis : Part 1 (Epidemiology, Pathophysiology and Clinical spectrum) |
| title_fullStr | Autoimmune encephalitis : Part 1 (Epidemiology, Pathophysiology and Clinical spectrum) |
| title_full_unstemmed | Autoimmune encephalitis : Part 1 (Epidemiology, Pathophysiology and Clinical spectrum) |
| title_short | Autoimmune encephalitis : Part 1 (Epidemiology, Pathophysiology and Clinical spectrum) |
| title_sort | autoimmune encephalitis part 1 epidemiology pathophysiology and clinical spectrum |
| topic | autoimmune encephalitis |
| url | https://samajournals.co.za/index.php/samj/article/view/780 |
| work_keys_str_mv | AT julianehiesgen autoimmuneencephalitispart1epidemiologypathophysiologyandclinicalspectrum AT claraschutte autoimmuneencephalitispart1epidemiologypathophysiologyandclinicalspectrum |