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The Queen Square Encephalitis Multidisciplinary Team Meeting - experience over three years, pre and post the COVID-19

Tehmina Bharucha1, Rachel L Brown2, Cristina Marcoci3

  • 1National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK; Department of Biochemistry, University of Oxford, Oxford OX1 3QU, UK.

Journal of the Neurological Sciences
|October 4, 2023
PubMed

Insights

A monthly multidisciplinary team meeting (MDT) improved diagnosis and management for complex encephalitis cases. This collaborative approach proved valuable, with most participants finding discussions useful and many reporting changes in patient care.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Immunology

Background:

  • Encephalitis diagnosis and treatment remain challenging, even in well-resourced settings.
  • A monthly multidisciplinary team meeting (MDT) was established in February 2018 to address these challenges.
  • The MDT aimed to improve diagnostic and therapeutic strategies for suspected encephalitis cases.

Purpose of the Study:

  • To describe the experience and outcomes of a multidisciplinary team meeting (MDT) for suspected encephalitis over three years.
  • To evaluate the impact of MDT discussions on patient diagnosis and management.
  • To assess the perceived value of the MDT by referring teams and attendees.

Main Methods:

  • Retrospective analysis of patient demographics, MDT outcomes, and final diagnoses.
  • Review of 324 case discussions involving 238 patients over a three-year period.
  • Analysis of feedback from an online survey of referring teams and MDT attendees.

Main Results:

  • Patient cases discussed were diverse, including COVID-19, brain infections, autoimmune disorders, and encephalitis mimics.
  • Approximately 40% of cases involved COVID-19 or brain infections, 40% autoimmune/inflammatory disorders, and 20% uncertain aetiologies.
  • 94% of survey respondents found the MDT discussions useful, and 69% reported a resulting change in patient management.

Conclusions:

  • Multidisciplinary input is essential for exploring diagnostic avenues and identifying novel treatments for encephalitis.
  • MDTs provide crucial support for clinicians managing complex cases, especially where specialist input is limited.
  • Collaborative decision-making in encephalitis management is vital, particularly when evidence bases are scarce.
Abstract

Keywords:
Autoimmune diseaseEncephalitisMeningitisMultidisciplinary teamMyelitisNeurological infections

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