Clinical profile of autoimmune encephalitis: Hospital-based study

Abstract

Background: Autoimmune encephalitis causes subacute deficits of memory and cognition, often followed by suppressed level of consciousness or coma. It is a difficult clinical situation due to the similarities in the clinical, imaging, and laboratory findings with many forms of other encephalitides. Materials and Methods: The aim of this article is to study the clinical profile of autoimmune encephalitis. This is a prospective observational study and conducted from August 2014 to July 2017 at Gauhati Medical College, Guwahati. Detailed neurological evaluation along with investigation was done in all the patients. Results and Observation: All patients are diagnosed and categorized as per diagnosis criteria led done by Graus et al. A total of 18 patients were included among which 13 (72%) patients were definite, 3 (16.66%) on probable, and 2 (11%) were possible. Out of the 18 patients, 8 (44%) were males and 10 (56%) were females. The average mean age was 31 ± 4 years and the duration of symptom was 7 weeks ± 4 days. Most common findings were psychiatric symptoms 16 (89%), cognitive decline and short-term memory loss 15 (83%), seizure 14 (78%), movement disorders (hyperkinetic) 13(72%), speech abnormalities 12 (67%), and autonomic dysfunction 4 (22%). Baseline investigations and cerebrospinal fluid analysis revealed pleocytosis along with neural autoantibodies positive in 13 (72%) patients. Electroencephalogram showed epileptiform discharges along with slowing. Magnetic resonance imaging is done in every patient and consistent with the finding of autoimmune encephalitis. Discussion and Conclusion: In the present study, patients presented with varied clinical features with positive neural autoantibodies. A broad approach to testing for infectious diseases and various autoantibodies can lead to the correct diagnosis.