autoimmune encephalitis

Question 1

Presentation

Answer 1

altered mental state. Non specific

Question 2

Investigations for suspected

Answer 2

Clinical history
General and neurological examination
Routine blood and CSF analysis
Neuroimaging (structural MRI)
EEG
Antibody testing

Question 3

Features and findings of autoimmune limbic encephalitis

Answer 3

Neuroimaging findings suggestive of medial temporal lobe involvement
Sub-acute onset (c. 3 months)
Altered mental state, cognitive dysfunction, seizures

Question 4

Features and findings of acute disseminated encephalomyelitis

Answer 4

Often post infective and in the under 40s
Multifocal neurological deficits
Variable encephalopathy

Question 5

Features and findings of NMDA receptor encephalitis

Answer 5

Predominantly affects the young and female
Psychosis, delusions, agitation, aggression, catatonia, seizures, irritability, insomnia, dysarthria, dyskinesia, cognitive impairment, decreased levels of consciousness
Abnormal EEG
Positive antibody tests (blood/CSF)

Question 6

Features and findings of Bickerstaff encephalitis

Answer 6

Impairment of consciousness, ataxia and ophthalmoparesis
Post infective
Often monophasic with a good prognosis

Question 7

What is autoimmune psychosis

Answer 7

Recent recognition that so-called ‘isolated psychotic presentations’ often test positive for neuronal antibodies (particularly anti NMDA receptor antibodies)
Psychiatric disturbance with neurological features (seizures, cognitive impairment and movement disorders)
Atypical presentation that ‘appears psychiatric’ but does not fit into schizophrenia of affective-related diagnostic criteria

Question 8

Presentation of autoimmune psychosis

Answer 8

Acute onset
Neurological signs (decreased consciousness, seizures, movement disorders, cognitive impairment)
Adverse response to antipsychotics