Autoimmune encephalitis: what is it, main symptoms and treatment

Autoimmune encephalitis is an inflammation of the brain that arises when the immune system attacks the brain cells themselves, impairing their functioning and causing symptoms such as tingling in the body, visual changes, convulsions or agitation, for example, which may or may not cause sequelae.

This illness is rare and can affect people of all ages. There are different types of autoimmune encephalitis, depending on the type of antibody that attacks the cells and the affected area of ​​the brain, including some of the main examples of anti-NMDAR encephalitis, acute disseminated encephalitis or limbic encephalitis, for example, which may arise due to a neoplasm, after infections or with no apparent cause.

Although autoimmune encephalitis does not have a specific cure, it can be treated with the use of certain medications, such as anticonvulsants, corticosteroids or immunosuppressants, for example, which relieve symptoms, reduce inflammation and help restore all brain function.

main symptoms

Because autoimmune encephalitis alters brain function, symptoms vary according to the affected region. However, the most common include:

• Weakness or changes in sensitivity in various parts of the body;
• Loss of balance;
• Difficulty to speak;
• Involuntary movements;
• Vision alterations, such as blurry vision;
• Difficulty understanding and memory changes;
• Changes in the sense of taste;
• Difficulty sleeping and frequent agitation;
• Changes in mood or personality.

In addition, when the communication between the neurons is very affected, symptoms such as hallucinations, delusions or paranoid thoughts can also appear.

In this way, certain cases of autoimmune encephalitis can be misdiagnosed, as being a psychiatric disorder of the type schizophrenia or bipolar disorder. When this occurs, the treatment is not carried out adequately and the symptoms may worsen over time or show significant signs of improvement.

What can cause encephalitis?

The specific cause of this type of encephalitis is not known and, in many cases, appears in healthy people. It is also believed that the autoantibodies could be originated after some types of infection by bacteria or virus, which could generate the production of inappropriate antibodies.

However, autoimmune encephalitis can also appear as one of the manifestations of a distant tumor, such as lung or uterine cancer, for example, what is called the paraneoplastic syndrome. Therefore, in the presence of an autoimmune encephalitis, it is necessary to investigate the presence of cancer.

How is the diagnosis performed?

To establish the correct diagnosis of this disease, it is important to consult a neurologist, because, in addition to evaluating the symptoms, it is essential to carry out other diagnostic procedures, such as analysis of the cerebrospinal fluid, magnetic resonance imaging or electroencephalogram, to detect brain lesions that indicate the existence of autoimmune encephalitis.

Blood tests can also be carried out to determine if there are antibodies that could cause this type of alteration. Some of the main autoantibodies are anti-NMDAR, anti-VGKC or anti-GlyR, for example, specific for each type of encephalitis.

Similarly, to investigate autoimmune encephalitis, the physician needs to rule out other more frequent causes of brain inflammation, such as viral or bacterial infections.

How is the treatment performed?

The treatment for autoimmune encephalitis starts with one or more of the following types of treatment:

• Use of corticosteroidssuch as Prednisone or Hidrocortisone, to reduce the response of the immune system;
• Use of immunosuppressantssuch as Rituximab or Cyclophosphamide, for a more potent reduction of the immune system;
• plasmapheresisto filter the blood and remove excess antibodies that are causing the illness;
• Immunoglobulin injectionsyou can replace the union of antibodies harmful to brain cells;
• tumor removal that could be giving rise to the antibodies that cause encephalitis.

Medications may also be necessary to reduce symptoms, such as anticonvulsants or anxiolytics, for example.

Likewise, it is important that the person affected by autoimmune encephalitis undergoes rehabilitation, being able to have the need for physical therapy, occupational therapy or psychiatric follow-up to reduce symptoms and reduce possible sequelae.