A clinical approach to diagnosis of autoimmune encephalitis

被引：2979

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

来源：

LANCET NEUROLOGY | 2016年 / 15卷 / 04期

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

页码：391 / 404

页数：14

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