Autoimmune Meningitis and Encephalitis

Megan B Richie1

  • 1Department of Neurology, University of California San Francisco, 505 Parnassus Avenue, Box 0114, San Francisco, CA 94143, USA.

Neurologic Clinics
|November 20, 2021
PubMed

Insights

Meningitis and encephalitis involve brain inflammation. Differentiating between autoimmune, infectious, or neoplastic causes requires careful evaluation of clinical factors and diagnostic tests like cerebrospinal fluid (CSF) analysis.

Area of Science:

  • Neurology
  • Immunology
  • Pathology

Background:

  • Meningitis and encephalitis are inflammatory conditions affecting the meninges and brain parenchyma.
  • Diagnosis relies on identifying inflammation via tissue pathology or cerebrospinal fluid (CSF) analysis.
  • Differential diagnosis must consider autoimmune, infectious, and neoplastic etiologies.

Purpose of the Study:

  • To outline the diagnostic approach for undifferentiated meningitis and encephalitis.
  • To emphasize the importance of considering autoimmune causes early in the diagnostic process.

Main Methods:

  • Clinical evaluation integrating patient risk factors and clinical syndrome.
  • Diagnostic workup including CSF analysis and Magnetic Resonance Imaging (MRI).
  • Assessment for specific neural autoantibodies when autoimmune etiology is suspected.

Main Results:

  • Simultaneous consideration of multiple potential causes is crucial for accurate diagnosis.
  • CSF analysis and MRI findings aid in narrowing the differential diagnosis.
  • Identifying specific neural autoantibodies is a key step if an autoimmune cause is suspected.

Conclusions:

  • A systematic approach is necessary for diagnosing meningitis and encephalitis.
  • Early consideration of autoimmune causes and targeted autoantibody testing can improve patient outcomes.