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Review
. 2014 Jun;27(3):361-8.
doi: 10.1097/WCO.0000000000000087.

Autoimmune encephalitis as differential diagnosis of infectious encephalitis

Thaís Armangue  1 , Frank Leypoldt, Josep Dalmau
Affiliations
Review

Autoimmune encephalitis as differential diagnosis of infectious encephalitis

Thaís Armangue et al. Curr Opin Neurol. 2014 Jun.

Abstract

Purpose of review: This review describes the main types of autoimmune encephalitis with special emphasis on those associated with antibodies against neuronal cell surface or synaptic proteins, and the differential diagnosis with infectious encephalitis.

Recent findings: There is a continuous expansion of the number of cell surface or synaptic proteins that are targets of autoimmunity. The most recently identified include the metabotropic glutamate receptor 5 (mGluR5), dipeptidyl-peptidase-like protein-6 (DPPX), and γ-aminobutyric acid-A receptor (GABAAR). In these and previously known types of autoimmune encephalitis [N-methyl-D-aspartate receptor (NMDAR), α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor (AMPAR), γ-aminobutyric acid-B receptor (GABABR), leucine-rich glioma inactivated protein 1 (LGI1), contactin-associated protein-like 2 (CASPR2)], the prodromal symptoms or types of presentations often suggest a viral encephalitis. We review here clues that help in the differential diagnosis with infectious encephalitis. Moreover, recent investigations indicate that viral encephalitis (e.g., herpes simplex) can trigger synaptic autoimmunity. In all these disorders, immunotherapy is usually effective.

Summary: Autoimmune encephalitis comprises an expanding group of potentially treatable disorders that should be included in the differential diagnosis of any type of encephalitis.

Video abstract: http://links.lww.com/CONR/A25,

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Conflict of interest statement

Conflict of interest:

Dr. Dalmau hold patents for the use of Ma2 and NMDAR as autoantibody tests, and has filed patents for the use of GABAAR and GABABR as diagnostic tests.

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