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Rev Neurol (Paris). 2018 Apr;174(4):228-236. doi: 10.1016/j.neurol.2017.11.004. Epub 2018 Mar 31.

Autoimmune encephalitis and psychiatric disorders.

Author information

1
Centre de référence maladies rares 'Syndromes neurologiques paranéoplasiques', hospices civils de Lyon, hôpital neurologique, neurologie B, 69677 Bron, France; INMG (NeuroMyoGene Institut), Inserm U1217/CNRS UMR 5310, 69372 Lyon, France; Université de Lyon - université Claude-Bernard Lyon 1, 69372 Lyon, France. Electronic address: jerome.honnorat@chu-lyon.fr.
2
Centre de référence maladies rares 'Syndromes neurologiques paranéoplasiques', hospices civils de Lyon, hôpital neurologique, neurologie B, 69677 Bron, France; INMG (NeuroMyoGene Institut), Inserm U1217/CNRS UMR 5310, 69372 Lyon, France; Université de Lyon - université Claude-Bernard Lyon 1, 69372 Lyon, France.

Abstract

Autoimmune encephalitis (AE) refers to a rare, newly described, group of diseases associated with specific circulating autoantibodies directed against neuronal proteins used as biomarkers of the disease. Characterization of the associated autoantibodies present in the patients' cerebrospinal fluid (CSF) and/or sera can differentiate the various AE subgroups, which have specific clinical presentations and prognoses, and is therefore essential for proposing appropriate treatments. As psychiatric symptoms may predominate at the onset or over the course of these diseases, the diagnosis is frequently delayed. Yet, patients' prognoses depend on the speed with which the disease is detected, identified and managed. A wide range of neuropsychiatric symptoms is observed according to the patient's AE subgroup, and some are highly suggestive of an immune origin and should be recognized as such by physicians. Because the presence of pronounced psychiatric symptoms drives patients to psychiatric institutions, which can hinder the diagnosis, physicians need to be aware of AE and propose the detection of autoantibodies as early as possible to provide optimal medical care to such patients. In fact, the description of AE subgroups over the past decade has allowed the present overview of their incidence in psychiatric diseases and some general guidelines for the management of these patients.

KEYWORDS:

Autoantibodies; Cancer; Dementia; Immunomodulatory therapy; Neuroimmunology; Organic psychosis; Paraneoplastic neurological syndrome; Schizophrenia; Synaptic receptors

PMID:
29609960
DOI:
10.1016/j.neurol.2017.11.004
[Indexed for MEDLINE]

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