Journal ArticleDOI
Clinical variables that help in predicting the presence of autoantibodies in patients with acute encephalitis.
Angélica Lizcano-Meneses,Nancy Watanabe,Felipe von Glehn,Renata Barbosa,Milena de Albuquerque,Clarissa L. Yassuda,Adriel S. Moraes,José Wiliam Martínez,Leonilda M.B. Santos,Fernando Cendes +9 more
TLDR
In this paper, clinical, EEG, brain MRI data, and antibodies against human neuronal antigens (NMDAR, GABAR, AMPAR, LGI1, CASPR2, and GAD) from 158 patients with criteria for possible autoimmune encephalitis were analyzed to create a predictive model for this disease.Abstract:
Objective To identify clinical variables that could predict the presence of autoantibodies in patients with acute encephalitis. Methods An observational, retrospective study from May 2011 to May 2017. Clinical, EEG, brain MRI data, and antibodies against human neuronal antigens (NMDAR, GABAR, AMPAR, LGI1, CASPR2, and GAD) from 158 patients with criteria for possible autoimmune encephalitis were analyzed to create a predictive model for this disease. Results We analyzed 158 samples, of which 18 cases were positive for anti-NMDAR, 2 for anti-LGI1, and 2 for anti-GAD. Seven of the 18 positive NMDAR patients were children, and 12 were female. Behavioral disorder, epileptic seizures, movement disorder, and altered level of consciousness were the frequent symptoms with >75 % sensitivity in positive anti-NMDAR patients. Other symptoms, such as language disorder, psychosis, hypoventilation, altered wake and sleep cycle, and cognitive impairment, had a sensitivity >55 %. Abnormal EEG findings had a high sensitivity (99.4 %). Brain MRI suggestive of encephalitis was observed in 7 of the positive cases for NMDAR. Abnormal CSF findings were reported in 12 patients positive for this receptor (sensitivity 70.6 %). With 7 of these symptoms, we obtained a sensitivity of 70 % and specificity of 81 % for the presence of anti-NMDAR antibodies (ROC Area 82 %). However, to predict that a patient with subacute encephalitis may have an autoimmune cause, the patient should include clinical manifestations such as movement disorder, behavioral disorder, hypoventilation, dysautonomia, and alteration of the wake and sleep cycle. Children were significantly more likely than adults with autoimmune encephalitis to experience chorea and status epilepticus (p Conclusions Anti-NMDAR encephalitis was more frequent in females and children. The repertoire of autoimmune encephalitis in children is different from adults. The presence of subacute behavioral changes, epileptic seizures, movement disorders, altered consciousness, hypoventilation, dysautonomia, and altered wake and sleep cycle predicted autoimmune encephalitis in our series.read more
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Journal ArticleDOI
Deep Learning-Enabled Identification of Autoimmune Encephalitis on 3D Multi-Sequence MRI.
Yayun Xiang,Chun Zeng,Baiyun Liu,Weixiong Tan,Jiangfen Wu,Xiaofei Hu,Yongliang Han,Qi Luo,Junwei Gong,Junhang Liu,Yongmei Li +10 more
TL;DR: In this paper, a deep learning (DL) algorithm using multi-sequence magnetic resonance imaging (MRI) for the identification of acute autoimmune encephalitis (AE) is presented.
References
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Epileptic seizures and epilepsy : Definitions proposed by the international league against epilepsy (ILAE) and the international bureau for epilepsy (IBE)
Ettore Beghi,Anne T. Berg,Arturo Carpio,Lars Forsgren,Dale C. Hesdorffer,W. Allen Hauser,Kristina Malmgren,Shlomo Shinnar,Nancy R. Temkin,David J. Thurman,Torbjörn Tomson +10 more
TL;DR: The International League Against Epilepsy (ILAE) and the International Bureau for Epilepsia (IBE) have come to consensus definitions for the terms epileptic seizure and epilepsy.
Journal ArticleDOI
Anti-N-Methyl-D-Aspartate Receptor (NMDAR) Encephalitis in Children and Adolescents
Nicole R. Florance,Rebecca Davis,Christopher Lam,Christina L. Szperka,Lei Zhou,Saba Ahmad,Cynthia J. Campen,Heather E. Moss,Nadja G. Peter,Amy J. Gleichman,Carol A. Glaser,David A. Lynch,David A. Lynch,Myrna R. Rosenfeld,Josep Dalmau +14 more
TL;DR: To report the clinical features of anti–N‐methyl‐D‐aspartate receptor (NMDAR) encephalitis in patients ≤ 18 years old.