Autoimmune Encephalitis in the ICU: Analysis of Phenotypes, Serologic Findings, and Outcomes

Neurocritical Care

Volumn 24, Issue 2, 2016, Pages 240-250

  Mittal, Manoj K ^a,b   Rabinstein, Alejandro A ^a   Hocker, Sara E ^a   Pittock, Sean J ^a   M Wijdicks, Eelco F ^a   McKeon, Andrew ^a  

^a MAYO CLINIC   (United States)

^b UNIVERSITY OF KANSAS SCHOOL OF MEDICINE   (United States)

Author keywords

Autoimmune; Encephalitis; Encephalopathy; ICU; Paraneoplastic

Indexed keywords

AMPA RECEPTOR; AZATHIOPRINE; CELL NUCLEUS ANTIGEN; CORTICOSTEROID; ETIRACETAM; GABAPENTIN; GLUTAMATE DECARBOXYLASE 65; HARKOSERIDE; HU ANTIBODY; IMMUNOGLOBULIN; IMMUNOGLOBULIN G; KETAMINE; MIDAZOLAM; MYCOPHENOLATE MOFETIL; MYELOBLASTIN; MYELOPEROXIDASE; N METHYL DEXTRO ASPARTIC ACID RECEPTOR; OPIATE; PENTOBARBITAL; PHENOBARBITAL; PHENYTOIN; RITUXIMAB; THYROID PEROXIDASE ANTIBODY; VALPROIC ACID;

ACUTE KIDNEY FAILURE; ADRENAL INSUFFICIENCY; ADULT; AGED; AGITATION; ALLERGIC ENCEPHALITIS; ANASARCA; ANEMIA; ARTICLE; CAUSE OF DEATH; CEREBROSPINAL FLUID EXAMINATION; CHOREA; CLINICAL ARTICLE; COGNITIVE DEFECT; CONTROLLED STUDY; DEMENTIA; DIFFUSION WEIGHTED IMAGING; DISABILITY; DISEASE SEVERITY; DISORDERS OF ACID BASE BALANCE; DRUG HYPERSENSITIVITY; ELECTROENCEPHALOGRAM; FEMALE; HEART ARRHYTHMIA; HEPARIN INDUCED THROMBOCYTOPENIA; HUMAN; HYPERHIDROSIS; HYPERKINESIA; HYPOTENSION; IMAGE ANALYSIS; IMMUNOTHERAPY; INTENSIVE CARE UNIT; LUNG EDEMA; MALE; MALIGNANT HYPERTENSION; MYOCLONUS; NEUROIMAGING; PLASMAPHERESIS; PRIORITY JOURNAL; SEIZURE; SEPSIS; TACHYCARDIA; TREATMENT RESPONSE; VEIN THROMBOSIS; AUTOIMMUNITY; BLOOD; CEREBROSPINAL FLUID; DRUG EFFECTS; ENCEPHALITIS; IMMUNOLOGY; LIMBIC ENCEPHALITIS; MIDDLE AGED; OUTCOME ASSESSMENT; PHENOTYPE; PHYSIOLOGY; YOUNG ADULT;

ADULT; AGED; AUTOIMMUNITY; ENCEPHALITIS; FEMALE; HUMANS; INTENSIVE CARE UNITS; LIMBIC ENCEPHALITIS; MALE; MIDDLE AGED; OUTCOME ASSESSMENT (HEALTH CARE); PHENOTYPE; YOUNG ADULT;

EID: 84941348079     PISSN: 15416933     EISSN: 15560961     Source Type: Journal    
DOI: 10.1007/s12028-015-0196-8     Document Type: Article

References (24)

1. Kelley BJ, Boeve BF, Josephs KA. Young-onset dementia: demographic and etiologic characteristics of 235 patients. Arch Neurol. 2008;65:1502–8.
2. Chitravas N, Jung RS, Kofskey DM, et al. Treatable neurological disorders misdiagnosed as Creutzfeldt-Jakob disease. Ann Neurol. 2011;70:437–44.
3. McKeon A. Immunotherapeutics for autoimmune encephalopathies and dementias. Curr Treat Options Neurol. 2013;15:723–37.
4. Flanagan EP, McKeon A, Lennon VA, et al. Autoimmune dementia: clinical course and predictors of immunotherapy response. Mayo Clin Proc. 2010;85:881–97.
5. Vincent A, Buckley C, Schott JM, et al. Potassium channel antibody-associated encephalopathy: a potentially immunotherapy-responsive form of limbic encephalitis. Brain. 2004;127:701–12.
6. Titulaer MJ, McCracken L, Gabilondo I, et al. Treatment and prognostic factors for long-term outcome in patients with anti-NMDA receptor encephalitis: an observational cohort study. Lancet Neurol. 2013;12:157–65.
7. Vitaliani R, Mason W, Ances B, Zwerdling T, Jiang Z, Dalmau J. Paraneoplastic encephalitis, psychiatric symptoms, and hypoventilation in ovarian teratoma. Ann Neurol. 2005;58:594–604.
8. McKeon A. Paraneoplastic and other autoimmune disorders of the central nervous system. Neurohospitalist. 2013;3:53–64.
9. Lai M, Huijbers MG, Lancaster E, et al. Investigation of LGI1 as the antigen in limbic encephalitis previously attributed to potassium channels: a case series. Lancet Neurol. 2010;9:776–85.
10. Irani SR, Michell AW, Lang B, et al. Faciobrachial dystonic seizures precede Lgi1 antibody limbic encephalitis. Ann Neurol. 2011;69:892–900.
11. Klein CJ, Lennon VA, Aston PA, et al. Insights from LGI1 and CASPR2 potassium channel complex autoantibody subtyping. JAMA Neurol. 2013;70:229–34.
12. Gresa-Arribas N, Titulaer MJ, Torrents A, et al. Antibody titres at diagnosis and during follow-up of anti-NMDA receptor encephalitis: a retrospective study. Lancet Neurol. 2014;13:167–77.
13. Herasevich V, Pickering BW, Dong Y, Peters SG, Gajic O. Informatics infrastructure for syndrome surveillance, decision support, reporting, and modeling of critical illness. Mayo Clin Proc. 2010;85:247–54.
14. O’Toole O, Lennon VA, Ahlskog JE, et al. Autoimmune chorea in adults. Neurology. 2013;80:1133–44.
15. Quek AM, Britton JW, McKeon A, et al. Autoimmune epilepsy: clinical characteristics and response to immunotherapy. Arch Neurol. 2012;69:582–93.
16. Hacohen Y, Wright S, Waters P, et al. Paediatric autoimmune encephalopathies: clinical features, laboratory investigations and outcomes in patients with or without antibodies to known central nervous system autoantigens. J Neurol Neurosurg Psychiatry. 2012;. doi:10.1136/jnnp-2012-303807.
17. McKeon A, Pittock SJ, Lennon VA. CSF complements serum for evaluating paraneoplastic antibodies and NMO-IgG. Neurology. 2011;76:1108–10.
18. Schmitt SE, Pargeon K, Frechette ES, Hirsch LJ, Dalmau J, Friedman D. Extreme delta brush: a unique EEG pattern in adults with anti-NMDA receptor encephalitis. Neurology. 2012;79:1094–100.
19. McKeon A, Pittock SJ. Paraneoplastic encephalomyelopathies: pathology and mechanisms. Acta Neuropathol. 2011;122:381–400.
20. McKeon A, Martinez-Hernandez E, Lancaster E, et al. Glycine receptor autoimmune spectrum with stiff-man syndrome phenotype. JAMA Neurol. 2013;70:44–50.
21. Pruss H, Dalmau J, Harms L, et al. Retrospective analysis of NMDA receptor antibodies in encephalitis of unknown origin. Neurology. 2010;75:1735–9.
22. Davies G, Irani SR, Coltart C, et al. Anti-N-methyl-D-aspartate receptor antibodies: a potentially treatable cause of encephalitis in the intensive care unit. Crit Care Med. 2010;38:679–82.
23. Martinez-Hernandez E, Horvath J, Shiloh-Malawsky Y, Sangha N, Martinez-Lage M, Dalmau J. Analysis of complement and plasma cells in the brain of patients with anti-NMDAR encephalitis. Neurology. 2011;77:589–93.
24. Thakur KT, Motta M, Asemota AO, et al. Predictors of outcome in acute encephalitis. Neurology. 2013;81:793–800.