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- Page navigation anchor for Improving recognition of autoimmune encephalitis: a reversible cause of cognitive impairment and disabilityImproving recognition of autoimmune encephalitis: a reversible cause of cognitive impairment and disability
I thank Drs Budhram et al for their timely review of the diagnosis of autoimmune encephalitis (AE),[1] which builds on a recent position paper proposing a clinically-grounded guideline for the diagnosis of AE.[2] A key take-home point is not to be overly dissuaded from treating clinically convincing cases of AE, once common differential diagnoses have been excluded, simply on the basis of negative antibody tests, given that new antibodies are being rapidly discovered and testing processes are still being refined. Timely recognition and treatment of AE is crucial to mitigate the consequent burden of cognitive impairment and neurological disability from this condition.[3] There remain serious challenges with the recognition of AE even among neurologists. For example, in a recent survey of 1,333 neurologists from 94 countries (with 12.0% identifying as neuro-immunologists), respondents were more eager to investigate and empirically treat a representative case of a 20-year-old woman with a neuropsychiatric presentation classically seen with anti-NMDAR encephalitis, than a companion case of a 40-year-old man with new temporal lobe seizures and cognitive impairment, despite both being viewed by interviewed experts as strongly suspicious for AE.[4] 92.3% of respondents chose to send an autoimmune antibody panel for the first case, whereas only 68.4% chose to do so for the second case; for empiric treatment, corresponding numbers were 85.1% and 40.3%. Neuroimmunologists and those...
Show MoreCompeting Interests: None declared.