Emergence of A New Entity: The Autoimmune Encephalitis
Keywords:Autoimmune encephalitis, auto antibodies, IUIG
Encephalitis has been known as a distinct entity for a long time but its exact cause has remained undetected in about half the cases in spite of extensive investigations. During the last few years there has been reports of cases of encephalitis in which antibodies has been detected against deep grey matter neurons. Antibodies have been detected against the N-methyl-D-aspartate (NMDA) receptors or voltage-gated potassium channels (VGKC). VGKC antibody positive encephalitis usually presents in middle aged or elderly people and is twice as common in men. The main symptoms are memory loss and seizures. Cognitive impairment, confusion, disorientation, personality change and behavioral disturbances are also common. Encephalitis associated with NMDA receptor antibodies is mainly seen in children and young adults, with women being affected about three to four times more often than men. Initially there is a period of cognitive impairment and psychiatric features like hallucinations, agitation and depression but later there is gradual deterioration in conscious level with autonomic features often requiring intensive care. The most striking feature of both these types of encephalitis is their uniform good response to immunomodulating therapies. Intravenous immunoglobulin (IVIG), glucocorticosteroids, plasma exchange and drugs like cyclophosphamide, rituximab, mycophenolate mofetil, azathioprine, singly or in combination have all produced good results. It is this surprisingly easily available effective treatment which makes diagnosis of this condition imperative. Encephalitis is a condition which is encountered by physicians at all levels and so a high level of awareness about the condition will ensure that the condition is not missed. This review about this new condition is being presented to make physicians aware about this devastating but easily treatable disease.
J Medicine 2012; 13 : 179-189
How to Cite
LicenseAuthors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).