Autoimmune Encephalitis: Insights Into Immune-Mediated Central Nervous System Injury
Vivek Pai1,2, Heejun Kang2,3, Suradech Suthiphosuwan2,4
1Division of Neuroradiology, Department of Diagnostic and Interventional Radiology, The Hospital for Sick Children, Toronto, Canada.
Korean Journal of Radiology
|August 28, 2024
Summary
Autoimmune encephalitis (AE) involves immune-mediated brain inflammation causing seizures and cognitive issues. Early detection through high clinical suspicion and MRI is crucial for prompt treatment and improved outcomes in patients with this central nervous system disorder.
Area of Science:
- Neuroimmunology
- Neurology
- Radiology
Background:
- Autoimmune encephalitis (AE) is a group of immune-mediated central nervous system (CNS) disorders.
- AE presents with subacute onset of altered mentation, neurocognitive deficits, refractory seizures, movement disorders, and autonomic dysfunction.
- Autoantibodies targeting CNS antigens trigger AE, leading to functional or structural brain alterations.
Purpose of the Study:
- To review the pathophysiology of autoimmune encephalitis.
- To discuss common etiologies of AE encountered in clinical practice.
- To highlight the importance of high clinical suspicion and MRI in diagnosing AE.
Main Methods:
- Review of existing literature on autoimmune encephalitis.
- Discussion of pathophysiology, triggers (parainfectious, paraneoplastic), and clinical manifestations.
- Analysis of neuroimaging features, particularly MRI findings in AE.
Main Results:
- AE pathogenesis involves autoantibodies against CNS targets.
- Common triggers include infections and neoplasms.
- Limbic encephalitis is a frequent MRI finding, though other brain regions can be involved.
- Imaging features often overlap with other encephalopathies, necessitating careful interpretation.
Conclusions:
- Increased understanding has led to higher incidence and detection of AE.
- High clinical suspicion is vital for prompt diagnosis and treatment.
- Early MRI interpretation is crucial for better patient outcomes in autoimmune encephalitis.
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