A clinical approach to diagnosis of autoimmune encephalitis

Francesc Graus, Maarten J. Titulaer, Ramani Balu, Susanne Benseler, Christian G. Bien, Tania Cellucci, Irene Cortese, Russell C. Dale, Jeffrey M. Gelfand, Michael Geschwind, Carol A. Glaser, Jerome Honnorat, Romana Höftberger, Takahiro Iizuka, Sarosh R. Irani, Eric Lancaster, Frank Leypoldt, Harald Prüss, Alexander Rae-Grant, Markus ReindlMyrna R. Rosenfeld, Kevin Rostásy, Albert Saiz, Arun Venkatesan, Angela Vincent, Klaus Peter Wandinger, Patrick Waters, Joseph Dalmau

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)391-404
Number of pages14
JournalThe Lancet Neurology
Volume15
Issue number4
DOIs
StatePublished - Apr 1 2016

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Differential Diagnosis
Immunotherapy
Brain Diseases
Encephalitis
Autoantibodies
Antibody Formation
Biomarkers
Guidelines
Hashimoto's encephalitis
Research
Therapeutics

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Graus, F., Titulaer, M. J., Balu, R., Benseler, S., Bien, C. G., Cellucci, T., ... Dalmau, J. (2016). A clinical approach to diagnosis of autoimmune encephalitis. The Lancet Neurology, 15(4), 391-404. https://doi.org/10.1016/S1474-4422(15)00401-9

A clinical approach to diagnosis of autoimmune encephalitis. / Graus, Francesc; Titulaer, Maarten J.; Balu, Ramani; Benseler, Susanne; Bien, Christian G.; Cellucci, Tania; Cortese, Irene; Dale, Russell C.; Gelfand, Jeffrey M.; Geschwind, Michael; Glaser, Carol A.; Honnorat, Jerome; Höftberger, Romana; Iizuka, Takahiro; Irani, Sarosh R.; Lancaster, Eric; Leypoldt, Frank; Prüss, Harald; Rae-Grant, Alexander; Reindl, Markus; Rosenfeld, Myrna R.; Rostásy, Kevin; Saiz, Albert; Venkatesan, Arun; Vincent, Angela; Wandinger, Klaus Peter; Waters, Patrick; Dalmau, Joseph.

In: The Lancet Neurology, Vol. 15, No. 4, 01.04.2016, p. 391-404.

Research output: Contribution to journalArticle

Graus, F, Titulaer, MJ, Balu, R, Benseler, S, Bien, CG, Cellucci, T, Cortese, I, Dale, RC, Gelfand, JM, Geschwind, M, Glaser, CA, Honnorat, J, Höftberger, R, Iizuka, T, Irani, SR, Lancaster, E, Leypoldt, F, Prüss, H, Rae-Grant, A, Reindl, M, Rosenfeld, MR, Rostásy, K, Saiz, A, Venkatesan, A, Vincent, A, Wandinger, KP, Waters, P & Dalmau, J 2016, 'A clinical approach to diagnosis of autoimmune encephalitis', The Lancet Neurology, vol. 15, no. 4, pp. 391-404. https://doi.org/10.1016/S1474-4422(15)00401-9
Graus F, Titulaer MJ, Balu R, Benseler S, Bien CG, Cellucci T et al. A clinical approach to diagnosis of autoimmune encephalitis. The Lancet Neurology. 2016 Apr 1;15(4):391-404. https://doi.org/10.1016/S1474-4422(15)00401-9
Graus, Francesc ; Titulaer, Maarten J. ; Balu, Ramani ; Benseler, Susanne ; Bien, Christian G. ; Cellucci, Tania ; Cortese, Irene ; Dale, Russell C. ; Gelfand, Jeffrey M. ; Geschwind, Michael ; Glaser, Carol A. ; Honnorat, Jerome ; Höftberger, Romana ; Iizuka, Takahiro ; Irani, Sarosh R. ; Lancaster, Eric ; Leypoldt, Frank ; Prüss, Harald ; Rae-Grant, Alexander ; Reindl, Markus ; Rosenfeld, Myrna R. ; Rostásy, Kevin ; Saiz, Albert ; Venkatesan, Arun ; Vincent, Angela ; Wandinger, Klaus Peter ; Waters, Patrick ; Dalmau, Joseph. / A clinical approach to diagnosis of autoimmune encephalitis. In: The Lancet Neurology. 2016 ; Vol. 15, No. 4. pp. 391-404.
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