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Updated: May 11, 2026
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Induction and Clinical Scoring of Chronic-Relapsing Experimental Autoimmune Encephalomyelitis
Published on: July 4, 2007
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Encephalitis Induced by Immune Checkpoint Inhibitors: A Systematic Review
Roser Velasco1,2, Macarena Villagrán3,4, Maria Jové5
1Neuro-Oncology Unit, Hospital Universitari de Bellvitge-Institut Català d Oncologia L'Hospitalet, Institut d´Investigació Biomèdica de Bellvitge, l'Hospitalet de Llobregat, Barcelona, Spain.
JAMA Neurology
|March 15, 2021
Summary
Immune checkpoint inhibitor-induced encephalitis (ICI-iE) often presents as focal or meningoencephalitis with generally favorable outcomes. However, specific autoantibodies and focal syndromes indicate a poorer prognosis, guiding treatment strategies.
Area of Science:
- Neuroimmunology
- Oncology
- Pharmacology
Background:
- Immune checkpoint inhibitors (ICIs) can cause severe immune-related adverse events, including encephalitis.
- Immune checkpoint inhibitor-induced encephalitis (ICI-iE) spectrum ranges from full recovery to fatal outcomes.
- ICIs may unmask underlying paraneoplastic encephalitis, a condition with a poor prognosis.
Purpose of the Study:
- To evaluate the clinical presentation of ICI-iE.
- To identify prognostic factors for ICI-iE outcomes.
Main Methods:
- Systematic review of case series (77) and single-center records (5).
- Inclusion criteria: English literature (2000-2020) on ICI-induced encephalitis with autoimmune features.
- Data extracted: clinical, CSF, MRI findings, and treatments.
Main Results:
- 82 patients analyzed; most presented with focal syndromes (48%) or meningoencephalitis (44%).
- Favorable prognosis observed in patients without focal syndromes or with negative autoantibodies (89%).
- Poor prognosis associated with antineuronal autoantibodies (71%), focal syndromes (41%), and abnormal MRI (36%).
Conclusions:
- ICI-iE typically presents as focal or meningoencephalitic syndromes with an overall favorable outcome.
- Presence of specific autoantibodies and focal syndromes are key indicators for prognosis.
- Systematic assessment of clinical presentation and autoantibodies aids therapeutic strategy and patient counseling.
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