Encephalitis/Encephalopathy is a life-threatening disease with many causes. Recent
advances in autoimmune encephalitis research led to the identification of syndromes
and biomarkers. Existing criteria for autoimmune encephalitis are too reliant on antibody
testing. Since antibody test results are not available at onset, a practical, syndrome-based
diagnostic approach is required. Diagnostic criteria for autoimmune limbic encephalitis
should be made when all four of the following criteria; #1Subacute onset of working
memory deficits, seizures, or psychiatric symptoms, #2 Brain abnormalities on MRI
at the medial temporal lobes, #3 At least one of the following including CSF pleocytosis,
or EEG with epileptic or slow-wave activity, and #4 Reasonable exclusion of alternative
causes. Anti N-methyl-D-Aspartate receptor encephalitis is most frequent in the autoimmune
encephalitis. Probable diagnosis should be made by the following criteria; #1 Acute
onset (less than 3 months) of at least four of the six following major groups of symptoms;
abnormal (psychiatric) behavior or cognitive dysfunction, speech dysfunction, seizures,
movement disorder, dyskinesia, or rigidity/abnormal postures, decreased level of consciousness,
autonomic dysfunction or central hypoventilation, #2 At least one of the following
laboratory study results including abnormal EEG, CSF with pleocytosis or oligoclonal
bands, #3 Reasonable exclusion of other disorders, and #4 diagnosis can also be made
in the presence of three of the above groups of symptoms accompanied by a systemic
teratoma. In the clinical management of autoimmune encephalitis, Bickerstaff ’s brainstem
encephalitis, acute disseminated encephalomyelitis and other demyelination, and Hashimoto’s
encephalopathy are listed as the differential diagnosis.
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