Antibody-mediated encephalitis
Alerts and Notices
Synopsis
This condition has many known antibodies and can present differently based on the antibody involved. Common presentations include mental status changes, headaches, psychiatric symptoms (anxiety, mood dysregulation, psychosis), memory disturbance, movement disorders, seizures, brain stem symptoms (dysphagia, nystagmus, opsoclonus, vertigo), and autonomic dysregulation. These conditions can occur in children and adults. Prognosis is variable based on the antibody involved, underlying malignancy, and severity of the neurologic syndrome.
LGI1 (leucine-rich, glioma-inactivated 1) antibody limbic encephalitis is a common type of limbic encephalitis associated with fatigue, hyponatremia, and faciobrachial dystonic seizures.
Codes
ICD10CM:G04.81 – Other encephalitis and encephalomyelitis
SNOMEDCT:
95643007 – Autoimmune encephalitis
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Migraine headache
- Postictal state
- Central nervous system lymphoma (see lymphomatous meningitis)
- Gliomatosis cerebri
- Progressive multifocal leukoencephalopathy
- Creutzfeldt-Jakob disease
- Osmotic demyelination syndrome
- Toxic encephalopathy
- Paraneoplastic syndromes (see paraneoplastic encephalomyelitis)
- Acute demyelinating encephalomyelitis
- Systemic lupus erythematosus
- Central nervous system vasculitis (see cerebral vasculitis)
- Post-traumatic (including post-concussion syndrome)
- Herpes simplex encephalitis
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Management Pearls
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Therapy
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References
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Last Reviewed:08/07/2018
Last Updated:05/25/2020
Last Updated:05/25/2020