Management of autoimmune encephalitis

被引:24
作者
Bien, Christian G. [1 ,2 ]
机构
[1] Bielefeld Univ, Med Sch, Krankenhaus Mara, Dept Epileptol, Campus Bielefeld Bethel, Bielefeld, Germany
[2] Lab Krone, Bad Salzuflen, Germany
关键词
acute symptomatic seizures; autoimmune encephalitis; immunotherapy; rehabilitation; rituximab; ANTIBODIES;
D O I
10.1097/WCO.0000000000000909
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Purpose of review Autoimmune encephalitides are established diagnoses in contemporary neurology. Their management poses a regular challenge for almost all neurologists. One may ask if the concept of 1(st) line and 2(nd) line treatment is still up to date, which new data on the antibody-defined encephalitis types exist, and how to organize long-term management. Recent findings The 1(st) line/2(nd) line concept of initial immunological intervention is accepted worldwide. A randomized controlled trial confirmed that one 1(st) line compound (intravenous immunoglobulins) is superior to a placebo in patients with antibodies against leucine-rich glioma inactivated protein 1. Rituximab, a 2(nd) line compound, is increasingly and apparently successfully used in treating different types of autoimmune encephalitis. It may find its place even earlier in the treatment cascade. Long-term management needs to be improved and is under development. There have been no groundbreaking new developments in the field. The published experience confirms existing suggestions. Aspects of long-term management including rehabilitation measures and counseling about driving eligibility require further research.
引用
收藏
页码:166 / 171
页数:6
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