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Induction and Clinical Scoring of Chronic-Relapsing Experimental Autoimmune Encephalomyelitis
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Neurobehavioral outcomes in autoimmune encephalitis.

Anusha K Yeshokumar1, Eliza Gordon-Lipkin2, Ana Arenivas3

  • 1Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States.

Journal of Neuroimmunology
|September 12, 2017
PubMed
Summary

Autoimmune encephalitis (AE) patients often experience lasting neurobehavioral issues, including cognitive deficits and fatigue, impacting daily life. These persistent symptoms require comprehensive assessment beyond routine neurological exams for optimal patient care.

Keywords:
Adaptive behaviorAntibody-mediatedAutoimmune encephalitisNeurobehavioral functionNeurocognitionNeurologic disability

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Area of Science:

  • Neuroscience
  • Immunology
  • Neurology

Background:

  • Autoimmune encephalitis (AE) is a group of disorders characterized by immune-mediated inflammation of the brain.
  • Long-term sequelae of AE can significantly impact patient quality of life, yet are not fully understood.
  • Identifying persistent neurobehavioral deficits is crucial for effective patient management.

Purpose of the Study:

  • To evaluate long-term neurobehavioral function in patients with clinically diagnosed autoimmune encephalitis.
  • To assess the prevalence of persistent cognitive, emotional, and adaptive behavior difficulties post-AE.
  • To determine if routine neurological assessments adequately capture long-term AE-related impairments.

Main Methods:

  • Retrospective chart review of 77 patients with clinically diagnosed AE over ten years.
  • Cross-sectional structured telephone interview with 44 AE participants.
  • Standardized assessment of adaptive behavior using the Adaptive Behavior Assessment System, Third Edition (ABAS-3).

Main Results:

  • 51% of patients had known AE-associated antibodies; 49% had no detected antibody.
  • 86% of interviewed participants reported ongoing difficulties (fatigue, emotional lability, memory, concentration).
  • 52% of participants scored below average on adaptive behavior assessment, including 40% with good neurological outcomes.

Conclusions:

  • Patients with autoimmune encephalitis frequently exhibit persistent neurobehavioral impairments.
  • These deficits in cognitive function and adaptive behavior may be underestimated by standard neurological evaluations.
  • Further research is needed to identify high-risk patients for targeted interventions and improved care.