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Neuroimaging and CSF Findings in Patients with Autoimmune Encephalitis: A Report of Eight Cases in a Single Academic Center

Authors :
Hongyan Wu
Hongxuyang Yu
Joe Joseph
Shruti Jaiswal
Shreya R. Pasham
Shitiz Sriwastava
Source :
Neurology International, Vol 14, Iss 1, Pp 176-185 (2022)
Publication Year :
2022
Publisher :
MDPI AG, 2022.

Abstract

Autoimmune Encephalitis (AIE) is a rare and complex group of disorders wherein the body’s immune system attacks and causes inflammatory changes in the central nervous system (CNS). It presents with altered mental status and a diverse range of typical and atypical symptoms and neuroimaging and cerebrospinal fluid (CSF) findings. The objective of this article is to highlight the importance of early identification of neurological symptoms, prompt diagnosis with neuroimaging and CSF findings, and timely management for early and complete resolution of the disease and long-term benefits. We report eight AIE cases from a single academic center confirmed by the presence of specific serum and CSF autoantibodies. The patients were mostly women, with imaging findings showing T2-weighted (T2), fluid-attenuated inversion recovery (FLAIR), hyperintensities/changes in cortical/mesio-temporal regions on a magnetic resonance imaging (MRI), and delta brush wave patterns or epileptogenic patterns on an electroencephalogram (EEG). Among the antibodies, the N-methyl-D-aspartate receptor (NMDA-R) antibody (AB) was most frequently identified, and CSF lymphocytosis and elevated CSF glucose were found in majority of the cases, CSF pleocytosis and elevated protein only in a minority of patients, and oligoclonal bands (OCBs) only in NMDA-R encephalitis. Early treatment with intravenous immune globulin (IVIG), steroids, plasmapheresis (PLEX), and rituximab was started in most cases, and all of them responded well and survived, but some had residual symptoms or relapses.

Details

Language :
English
ISSN :
20358377
Volume :
14
Issue :
1
Database :
Directory of Open Access Journals
Journal :
Neurology International
Publication Type :
Academic Journal
Accession number :
edsdoj.15dee8122cd4657a708db2971147193
Document Type :
article
Full Text :
https://doi.org/10.3390/neurolint14010014