Neurobehavioral outcomes in autoimmune encephalitis

J Neuroimmunol. 2017 Nov 15;312:8-14. doi: 10.1016/j.jneuroim.2017.08.010. Epub 2017 Aug 31.

Abstract

This study evaluates long-term neurobehavioral function in patients with clinically diagnosed autoimmune encephalitis (AE) of various etiologies through retrospective chart review and a cross-sectional structured telephone interview. Of 77 patients meeting clinical diagnostic criteria for AE over a ten year period, 39/77 (51%) patients had known AE-associated antibodies, and 38/77 (49%) had no detected antibody. 9/77 (12%) died, and 26/77 (34%) had "poor" neurologic disability score (mRS 3-5) at the last documented follow-up. 44 participants enrolled in the telephone interview, of whom 38/44 (86%) endorsed ongoing difficulties with fatigue, emotional lability, short-term memory, and/or concentration. On standardized assessment of adaptive behavior (ABAS-3), 23/44 (52%) scored "below average" (general adaptive composite: mean 86.95, standard deviation 18.45). Of the participants with "good" neurologic disability outcome (mRS 0-2), 12/30 (40%) scored "below average" in adaptive behavior. In summary, patients with AE frequently have persistent impairments in neurologic disability, neurocognitive symptomatology, and adaptive behavior, which may not be adequately captured by routine neurologic assessments. Comprehensively elucidating these persistent neurobehavioral impairments and predicting which patients are at highest risk will allow for optimal care of patients and their families.

Keywords: Adaptive behavior; Antibody-mediated; Autoimmune encephalitis; Neurobehavioral function; Neurocognition; Neurologic disability.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cross-Sectional Studies
  • Disabled Persons
  • Encephalitis / complications*
  • Encephalitis / epidemiology
  • Female
  • Hashimoto Disease / complications*
  • Hashimoto Disease / epidemiology
  • Humans
  • Longitudinal Studies
  • Male
  • Medical Records / statistics & numerical data
  • Mental Disorders / etiology*
  • Middle Aged
  • Nervous System Diseases / epidemiology
  • Nervous System Diseases / etiology*
  • Young Adult

Supplementary concepts

  • Hashimoto's encephalitis