Autoimmune encephalitis, Hashimoto. MR of the brain. Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China. Open
Contents
- 1 Definition
- 2 Symptoms
- 3 Examinations
- 4 Diagnosis
- 5 Incorrect diagnosis (similar conditions, differential diagnoses)
- 5.1 Virus encephalitis
- 5.2 Bacterial infection
- 5.3 Mumps infection (in case of impaired immune system due to medication or HIV)
- 5.4 CNS vasculitis (in the blood vessels of the brain)
- 5.5 Systemic lupus erythematosus (SLE) with affection of the brain
- 5.6 Wernicke encephalitis
- 5.7 intoxication
- 5.8 Lymphoma
- 5.9 Carcinomatic meningitis
- 6 Literature
Definition
Autoimmune encephalitis is a disease in which the immune system attacks the brain. The symptoms are increasing over days-weeks. Some cases are related to other autoimmune diseases, including Systemic lupus erythematosus (SLE) or autoimmune metabolic disease (Hashimoto's thyroiditis). Others may have a underlying cancer.
- There are several types of autoimmune encephalitis that are separated by symptoms, antibody in blood and spinal fluid and other examination findings
- The disease must be investigated and treated by a neurologist
Symptoms
- Headache
- Mentaly unclear
- Hallucinations
- Aggressiveness
- Memory impairment
- Convulsions
Examinations
- MR of brain and brain stem
- PET / CT of the brain
- EEG
- Spinal Fluid
- Antibody in blood (serum) and spinal fluid
- In a large part of the cases, more or less typical antibody tests may turn out positive. However, low titer results must be interpreted with caution because "false positive" results are irrelevant.
- The antibodies are directed to proteins in central nervous system (CNS). These can be membrane receptors og ion channel associated proteins on the surface of neurons
- Thyroid antibody (anti-TPO) by Hashimoto's thyroiditis og Hashimoto Encephalitis (SREAT)
Diagnosis
- Disease history
- Examinations
- Exclude infections and other
Incorrect diagnosis (similar conditions, differential diagnoses)
-
Virus encephalitis
- Herpes simplex
- Enterovirus
- West Nile Virus
- Ebstein-Barr Virus (EBV)
-
Bacterial infection
- Listeria
- Streptococcus
- Syphilis
- Borrelia/Lyme disease
- Tuberkulosis (Tbc)
-
Mushroom infection (in weakened immune system due to medication or HIV)
- More comprehensive list of infections that can attack the brain here (in Danish) (Wikipedia)
-
CNS vasculitis (in the blood vessels of the brain)
-
Systemic lupus erythematosus (SLE) with affection of the brain
-
Wernicke encephalitis
-
intoxication
-
Lymphoma
-
Carcinomatic meningitis
Literature
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