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Kvam KA, Stahl JP, Chow FC, Soldatos A, Tattevin P, Sejvar J, Mailles A. Outcome and Sequelae of Autoimmune Encephalitis. J Clin Neurol 2024; 20:3-22. [PMID: 38179628 PMCID: PMC10782092 DOI: 10.3988/jcn.2023.0242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 10/31/2023] [Accepted: 11/06/2023] [Indexed: 01/06/2024] Open
Abstract
Autoimmune etiologies are a common cause for encephalitis. The clinical syndromes consistent with autoimmune encephalitis are both distinct and increasingly recognized, but less is known about persisting sequelae or outcomes. We searched PubMed for reports on outcomes after autoimmune encephalitis. Studies assessing validated, quantitative outcomes were included. We performed a narrative review of the published literature of outcomes after autoimmune encephalitis. We found 146 studies that produced outcomes data. The mortality rates were 6%-19% and the relapse risks were 10%-62%. Most patients achieved a good outcome based on a score on the modified Rankin Scale (mRS) of ≤2. Forty-nine studies evaluated outcomes beyond mRS; these studies investigated cognitive outcome, psychiatric sequelae, neurological deficits, global function, and quality-of-life/patient-reported outcomes using various tools at varying time points after the index hospital discharge. These more-detailed assessments revealed that most patients had persistent impairments, with frequent deficits in cognitive function, especially memory and attention. Depression and anxiety were also common. Many of these sequelae continued to improve over months or even years after the acute illness. While we found that lasting impairments were common among survivors of autoimmune encephalitis, additional research is needed to better understand the nature and impact of these sequelae. Standardized evaluation protocols are needed to improve the ability to compare outcomes across studies, guide rehabilitation strategies, and inform outcomes of interest in treatment trials as the field advances.
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Affiliation(s)
- Kathryn A Kvam
- Department of Neurology & Neurological Sciences, Center for Academic Medicine, Stanford University, Stanford, CA, USA.
| | | | - Felicia C Chow
- Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
- Department of Medicine, Division of Infectious Diseases, University of California, San Francisco, CA, USA
| | - Ariane Soldatos
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Pierre Tattevin
- Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France
| | - James Sejvar
- Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Alexandra Mailles
- Department of Infectious Diseases, Santé publique France, Saint-Maurice, France
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Du Y, Zhao C, Liu J, Li C, Yan Q, Li L, Hao Y, Yao D, Si H, Zhao Y, Zhang W. Correction: Simplified regimen of combined low-dose rituximab for autoimmune encephalitis with neuronal surface antibodies. J Neuroinflammation 2022; 19:309. [PMID: 36544192 PMCID: PMC9773434 DOI: 10.1186/s12974-022-02644-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Affiliation(s)
- Ying Du
- grid.460007.50000 0004 1791 6584Department of Neurology, Tangdu Hospital, Fourth Military Medical University, Xi’an City, 710038 Shaanxi Province China
| | - Chao Zhao
- grid.460007.50000 0004 1791 6584Department of Neurology, Tangdu Hospital, Fourth Military Medical University, Xi’an City, 710038 Shaanxi Province China
| | - Juntong Liu
- grid.460007.50000 0004 1791 6584Department of Neurology, Tangdu Hospital, Fourth Military Medical University, Xi’an City, 710038 Shaanxi Province China
| | - Chuan Li
- grid.460007.50000 0004 1791 6584Department of Neurology, Tangdu Hospital, Fourth Military Medical University, Xi’an City, 710038 Shaanxi Province China
| | - Qi Yan
- grid.460007.50000 0004 1791 6584Department of Neurology, Tangdu Hospital, Fourth Military Medical University, Xi’an City, 710038 Shaanxi Province China
| | - Lin Li
- grid.460007.50000 0004 1791 6584Department of Neurology, Tangdu Hospital, Fourth Military Medical University, Xi’an City, 710038 Shaanxi Province China
| | - Yunfeng Hao
- grid.460007.50000 0004 1791 6584Department of Neurology, Tangdu Hospital, Fourth Military Medical University, Xi’an City, 710038 Shaanxi Province China
| | - Dan Yao
- grid.460007.50000 0004 1791 6584Department of Neurology, Tangdu Hospital, Fourth Military Medical University, Xi’an City, 710038 Shaanxi Province China
| | - Huaxing Si
- grid.460007.50000 0004 1791 6584Department of Neurology, Tangdu Hospital, Fourth Military Medical University, Xi’an City, 710038 Shaanxi Province China
| | - Yingjun Zhao
- grid.12955.3a0000 0001 2264 7233Fujian Provincial Key Laboratory of Neurodegenerative Disease and Aging Research, Institute of Neuroscience, School of Medicine, Xiamen University, Xiamen, 361005 China
| | - Wei Zhang
- grid.460007.50000 0004 1791 6584Department of Neurology, Tangdu Hospital, Fourth Military Medical University, Xi’an City, 710038 Shaanxi Province China
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