A clinical approach to diagnosis of autoimmune encephalitis

被引:2812
作者
Graus, Francesc [1 ,2 ]
Titulaer, Maarten J. [3 ]
Balu, Ramani [4 ]
Benseler, Susanne [5 ]
Bien, Christian G. [6 ]
Cellucci, Tania [7 ]
Cortese, Irene [8 ]
Dale, Russell C. [9 ]
Gelfand, Jeffrey M. [10 ]
Geschwind, Michael
Glaser, Carol A. [11 ,12 ]
Honnorat, Jerome [13 ]
Hoeftberger, Romana [14 ]
Iizuka, Takahiro [15 ]
Irani, Sarosh R. [16 ]
Lancaster, Eric [4 ]
Leypoldt, Frank [17 ,18 ]
Pruess, Harald [19 ,20 ]
Rae-Grant, Alexander [21 ]
Reindl, Markus [22 ]
Rosenfeld, Myrna R. [1 ]
Rostasy, Kevin [23 ]
Saiz, Albert [1 ,2 ]
Venkatesan, Arun [24 ]
Vincent, Angela [16 ]
Wandinger, Klaus-Peter [25 ,26 ]
Waters, Patrick [16 ]
Dalmau, Josep [1 ,4 ,27 ]
机构
[1] Inst Invest Biomed August Pi & Sunyer, Neuroimmunol Program, Barcelona, Spain
[2] Hosp Clin Barcelona, Serv Neurol, Barcelona, Spain
[3] Erasmus MC, Dept Neurol, Rotterdam, Netherlands
[4] Univ Penn, Dept Neurol, Philadelphia, PA 19104 USA
[5] Alberta Children Hosp, Dept Pediat, Calgary, AB, Canada
[6] Krankenhaus Mara, Epilepsy Ctr Bethel, Bielefeld, Germany
[7] McMaster Univ, Dept Pediat, McMaster Childrens Hosp, Hamilton, ON, Canada
[8] NINDS, Neuroimmunol Clin, NIH, Bldg 36,Rm 4D04, Bethesda, MD 20892 USA
[9] Univ Sydney, Neuroimmunol Grp, Childrens Hosp Westmead, Sydney, NSW 2006, Australia
[10] Univ Calif San Francisco, Dept Neurol, San Francisco, CA 94143 USA
[11] Kaiser Permanente, Div Pediat Infect Dis, Oakland Med Ctr, San Francisco, CA USA
[12] Univ Calif San Francisco, San Francisco, CA 94143 USA
[13] Univ Lyon 1, French Reference Ctr Paraneoplast Neurol Syndrome, Hosp Civils Lyon, Hop Neurol,Inserm U1028,CNRS UMR 5292,Lyons Neuro, F-69365 Lyon, France
[14] Med Univ Vienna, Inst Neurol, Vienna, Austria
[15] Kitasato Univ, Sch Med, Dept Neurol, Sagamihara, Kanagawa, Japan
[16] Univ Oxford, John Radcliffe Hosp, Nuffield Dept Clin Neurosci, Oxford OX3 9DU, England
[17] Univ Med Ctr Schleswig Holstein, Inst Clin Chem, Neuroimmunol, Kiel, Germany
[18] Univ Med Ctr Schleswig Holstein, Dept Neurol, Kiel, Germany
[19] Charite, Dept Neurol, D-13353 Berlin, Germany
[20] German Ctr Neurodegenerat Disorders Berlin, Berlin, Germany
[21] Cleveland Clin Fdn, Dept Neurol, 9500 Euclid Ave, Cleveland, OH 44195 USA
[22] Med Univ Innsbruck, Dept Clin Neurol, A-6020 Innsbruck, Austria
[23] Univ Witten Herdecke, Childrens Hosp Datteln, Dept Pediat Neurol, Datteln, Germany
[24] Johns Hopkins Univ, Sch Med, Dept Neurol, Baltimore, MD 21205 USA
[25] Univ Hosp Schleswig Holstein, Inst Clin Chem, Lubeck, Germany
[26] Univ Hosp Schleswig Holstein, Dept Neurol, Lubeck, Germany
[27] ICREA, Barcelona, Spain
基金
英国医学研究理事会; 美国国家卫生研究院;
关键词
D-ASPARTATE RECEPTOR; HERPES-SIMPLEX ENCEPHALITIS; GLUTAMIC-ACID DECARBOXYLASE; BRAIN-STEM ENCEPHALITIS; ACUTE DISSEMINATED ENCEPHALOMYELITIS; LIMBIC ENCEPHALITIS; CASE SERIES; MULTIPLE-SCLEROSIS; CASE DEFINITIONS; NEUROLOGICAL SYNDROMES;
D O I
10.1016/S1474-4422(15)00401-9
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Encephalitis is a severe inflammatory disorder of the brain with many possible causes and a complex differential diagnosis. Advances in autoimmune encephalitis research in the past 10 years have led to the identification of new syndromes and biomarkers that have transformed the diagnostic approach to these disorders. However, existing criteria for autoimmune encephalitis are too reliant on antibody testing and response to immunotherapy, which might delay the diagnosis. We reviewed the literature and gathered the experience of a team of experts with the aims of developing a practical, syndrome-based diagnostic approach to autoimmune encephalitis and providing guidelines to navigate through the differential diagnosis. Because autoantibody test results and response to therapy are not available at disease onset, we based the initial diagnostic approach on neurological assessment and conventional tests that are accessible to most clinicians. Through logical differential diagnosis, levels of evidence for autoimmune encephalitis (possible, probable, or definite) are achieved, which can lead to prompt immunotherapy.
引用
收藏
页码:391 / 404
页数:14
相关论文
共 109 条
  • [1] Limbic encephalitis and small cell lung cancer - Clinical and immunological features
    Alamowitch, S
    Graus, F
    Uchuya, M
    Rene, R
    Bescansa, E
    Delattre, JY
    [J]. BRAIN, 1997, 120 : 923 - 928
  • [2] Immunology of stiff person syndrome and other GAD-associated neurological disorders
    Alexopoulos, Harry
    Dalakas, Marinos C.
    [J]. EXPERT REVIEW OF CLINICAL IMMUNOLOGY, 2013, 9 (11) : 1043 - 1053
  • [3] Treatment-responsive limbic encephalitis identified by neuropil antibodies: MRI and PET correlates
    Ances, BM
    Vitaliani, R
    Taylor, RA
    Liebeskind, DS
    Voloschin, A
    Houghton, DJ
    Galetta, SL
    Dichter, M
    Alavi, A
    Rosenfeld, MR
    Dalmau, J
    [J]. BRAIN, 2005, 128 : 1764 - 1777
  • [4] Paraneoplastic Neurological Syndromes and Glutamic Acid Decarboxylase Antibodies
    Arino, Helena
    Hoeftberger, Romana
    Gresa-Arribas, Nuria
    Martinez-Hernandez, Eugenia
    Armangue, Thais
    Kruer, Michael C.
    Arpa, Javier
    Domingo, Julio
    Rojc, Bojan
    Bataller, Luis
    Saiz, Albert
    Dalmau, Josep
    Graus, Francesc
    [J]. JAMA NEUROLOGY, 2015, 72 (08) : 874 - 881
  • [5] Autoimmune post-herpes simplex encephalitis of adults and teenagers
    Armangue, Thais
    Moris, German
    Cantarin-Extremera, Veronica
    Enrique Conde, Carlos
    Rostasy, Kevin
    Elena Erro, Maria
    Carlos Portilla-Cuenca, Juan
    Turon-Vinas, Eulalia
    Malaga, Ignacio
    Munoz-Cabello, Beatriz
    Torres-Torres, Carmen
    Llufriu, Sara
    Gonzalez-Gutierrez-Solana, Luis
    Gonzalez, Guillermo
    Casado-Naranjo, Ignacio
    Rosenfeld, Myrna
    Graus, Francesc
    Dalmau, Josep
    [J]. NEUROLOGY, 2015, 85 (20) : 1736 - 1743
  • [6] WHEN A SERUM TEST OVERRIDES THE CLINICAL ASSESSMENT
    Armangue, Thais
    Santamaria, Joan
    Dalmau, Josep
    [J]. NEUROLOGY, 2015, 84 (13) : 1379 - 1381
  • [7] Herpes simplex virus encephalitis is a trigger of brain autoimmunity
    Armangue, Thais
    Leypoldt, Frank
    Malaga, Ignacio
    Raspall-Chaure, Miquel
    Marti, Itxaso
    Nichter, Charles
    Pugh, John
    Vicente-Rasoamalala, Monica
    Lafuente-Hidalgo, Miguel
    Macaya, Alfons
    Ke, Michael
    Titulaer, Maarten J.
    Hoeftberger, Romana
    Sheriff, Heather
    Glaser, Carol
    Dalmau, Josep
    [J]. ANNALS OF NEUROLOGY, 2014, 75 (02) : 317 - 323
  • [8] Autoimmune Encephalitis in Children
    Armangue, Thais
    Petit-Pedrol, Mar
    Dalmau, Josep
    [J]. JOURNAL OF CHILD NEUROLOGY, 2012, 27 (11) : 1460 - 1469
  • [9] High Grade Glioma Mimicking Voltage Gated Potassium Channel Complex Associated Antibody Limbic Encephalitis
    Athauda, Dilan
    Delamont, R. S.
    De Pablo-Fernandez, E.
    [J]. CASE REPORTS IN NEUROLOGICAL MEDICINE, 2014, 2014
  • [10] Development of case definitions for acute encephalopathy, encephalitis, and multiple sclerosis reports to the Vaccine Adverse Event Reporting System
    Ball, R
    Halsey, N
    Braun, NM
    Moulton, LH
    Gale, AD
    Rammohan, K
    Wiznitzer, M
    Johnson, R
    Salive, ME
    [J]. JOURNAL OF CLINICAL EPIDEMIOLOGY, 2002, 55 (08) : 819 - 824