Overview
Autoimmune encephalitis (AE) causes a wide spectrum of neuropsychiatric symptoms. Though individual AE subtypes often have a characteristic symptom cluster, it is important to remember that each case is unique. Presentations can differ considerably, even amongst AE patients diagnosed with the same antibody.
Symptoms can occur acutely or subacutely, and typically involve a combination of:
Symptoms can occur acutely or subacutely, and typically involve a combination of:
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Psychiatric symptoms
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by the Subtype: CHaracteristic symptom clusters
In limbic encephalitis (LE), the most common symptoms are memory loss, seizures, anterograde amnesia (the inability to store new memories after the onset of the condition), anxiety, depression, irritability, personality change, acute confusional state, and hallucinations. Less common symptoms include weight changes, insomnia, obsessiveness, hyperthermia (increase in body temperature), endocrine dysfunction, and aphasia. The symptoms associated with limbic encephalitis can develop over a few days, weeks, or months. For those with paraneoplastic limbic encephalitis (i.e. LE associated with a malignancy), neurological symptoms generally precede diagnosis of the malignancy in 60%-75% of patients.
In anti-NMDA receptor encephalitis, symptoms typically strike abruptly and include psychosis and mental decline. There are numerous other symptoms that this disorder produces, including fever, headache, malaise, memory loss, and sleep disorders, seizures, language difficulty, movement disorders, among others. On average, this subtype tends to have better outcomes than others provided proper treatment is administered.
In LGI1-antibody encephalitis, the development of symptoms tends to be more subacute. They include cognitive impairment, faciobrachial dystonic seizures, seizures, and mental and behavioural abnormalities.
In Hashimoto's encephalitis, the symptoms can be highly variable. Patients range from those who experience a sudden onset of confusion and altered consciousness, to those who experience a more subacute course characterized by slowly progressive cognitive impairment with dementia, confusion, seizures, motor issues, tremors, hallucinations, paranoia, or severe fatigue. On average, this subtype is less likely to progress to hospitalization, but is more likely to cause a relapsing-remitting course of disease.
In seronegative encephalitis, the clinical presentation can span the spectrum of cognitive impairment, behavioral changes, personality changes, seizures, abnormal movements, autonomic disturbances, decreased level of sensorium, hallucinations, tremors, and memory loss.
In anti-GABABR encephalitis, patients typically suffer from seizures, cognitive disorders, behavioral changes) and other uncommon clinical syndromes, such as cerebellar ataxia and opsoclonus-myoclonus syndrome.
In anti-NMDA receptor encephalitis, symptoms typically strike abruptly and include psychosis and mental decline. There are numerous other symptoms that this disorder produces, including fever, headache, malaise, memory loss, and sleep disorders, seizures, language difficulty, movement disorders, among others. On average, this subtype tends to have better outcomes than others provided proper treatment is administered.
In LGI1-antibody encephalitis, the development of symptoms tends to be more subacute. They include cognitive impairment, faciobrachial dystonic seizures, seizures, and mental and behavioural abnormalities.
In Hashimoto's encephalitis, the symptoms can be highly variable. Patients range from those who experience a sudden onset of confusion and altered consciousness, to those who experience a more subacute course characterized by slowly progressive cognitive impairment with dementia, confusion, seizures, motor issues, tremors, hallucinations, paranoia, or severe fatigue. On average, this subtype is less likely to progress to hospitalization, but is more likely to cause a relapsing-remitting course of disease.
In seronegative encephalitis, the clinical presentation can span the spectrum of cognitive impairment, behavioral changes, personality changes, seizures, abnormal movements, autonomic disturbances, decreased level of sensorium, hallucinations, tremors, and memory loss.
In anti-GABABR encephalitis, patients typically suffer from seizures, cognitive disorders, behavioral changes) and other uncommon clinical syndromes, such as cerebellar ataxia and opsoclonus-myoclonus syndrome.