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Peng et al. Neuroimmunol Neuroinflammation 2017;4:132-5 Neuroimmunology and
DOI: 10.20517/2347-8659.2016.50
Neuroinflammation

www.nnjournal.net
Commentary Open Access

Hot topics of autoimmune encephalitis

Ying Peng , Jia-Wei Wang 1,2
1
1 Department of Neurology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.
2 Department of Medical Research Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.
Correspondence to: Dr. Jia-Wei Wang, Department of Medical Research Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100730,
China. E-mail: wangjwcq@163.com

How to cite this article: Peng Y, Wang JW. Hot topics of autoimmune encephalitis. Neuroimmunol Neuroinflammation 2017;4:132-5.

Article history: Received: 24-11-2016 Accepted: 20-03-2017 Published: 11-07-2017

INTRODUCTION of the disorder, earlier treatment, andincreasing use
of second-line immunotherapy. Early diagnosis of
[4]
Within the last few years, a new group of diseases these disorders is, therefore, required.
featured with cognitive impairment, seizures and
behavior disorders was reported. And these diseases DISCUSSIONS ON “A CLINICAL APPROACH
were commonly diagnosed as “viral encephalitis” and TO DIAGNOSIS OF AUTOIMMUNE
“sporadic encephalitis” than autoimmune encephalitis
(AE) before AE had confirmed etiological. With the ENCEPHALITIS”
development of autoantibody serological tests, many
patients who had been previously considered as In a paper published in The Lancet Neurology,
[5]
patients with “viral encephalitis” can now be definitively Graus et al. propose new guidelines for the
diagnosed with AE. Currently, AE has become one diagnosis of AE. This guideline includes five diseases
of the hotspots in neuroimmunology. A retrospective involving limbic encephalitis (LE), anti-NMDAR
review suggests that earlier treatment of N-methyl- encephalitis, Bickerstaff brain stem encephalitis,
D-aspartate receptor (NMDAR) antibody encephalitis acute disseminated encephalomyelitis (ADEM) and
in children results in better outcomes. Also, there is hashimoto encephalopathy. These diseases show
[1]
another study that showed that people who received some similar characteristics of onset and clinical
immunotherapy within 40 days from onset had a better features. When AE is suspected, a stepwise diagnosis
recovery than those who received immunotherapy after should be made according to the recommended
40 days from onset. Therefore, early immunotherapy
[2]
could improve the prognosis of AE. Also, treatment diagnostic path. This guideline classifies the
regimens vary from different types of AE. For example, diagnosis of AE into three levels: possible, probable
anti-NMDAR (detected) encephalitis usually requires and definite. The two former levels do not rely on the
intensive immunosuppression, whereas encephalitis tests of auto-antibodies, while the definite diagnosis
associated with LGI1 antibodies usually responds of AE generally need positive antibody result. Each
well to steroids alone. The lower frequency of level needs some supportive and exclusive points to
[3]
neurological relapses is likely due to better recognition diagnosis.

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