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, seizures or agitation, for example, which may or may not leave sequelae.
This disease is rare, and can affect people of all ages. There are different types of autoimmune encephalitis, as they depend on the type of antibody that attacks the cells and the area of the brain affected, with some of the main examples being anti-NMDA encephalitis, acute disseminated encephalitis or limbic encephalitis for example, which can arise due to a neoplasm, after infections or without a clear cause.
Although autoimmune encephalopathy has no specific cure, it can be treated with the use of some medications, such as anticonvulsants, corticosteroids or immunosuppressants, for example, which relieve symptoms, reduce inflammation and help restore all brain functioning capabilities.
Main symptoms
Since autoimmune encephalitis affects the functioning of the brain, symptoms vary according to the affected region. However, the most common signs include:
- Weakness or changes in sensitivity in various parts of the body; Loss of balance; Difficulty speaking; Involuntary movements; Changes in vision, such as blurred vision; Difficulty understanding and memory changes; Changes in taste; Difficulty sleeping and frequent agitation; Changes of humor or personality.
In addition, when communication between neurons is greatly affected, they can also arise as hallucinations, delusions or paranoid thoughts.
Thus, some cases of autoimmune encephalitis may be misdiagnosed, such as a psychiatric disorder of the type schizophrenia or bipolar disorder. When this happens, the treatment is not done properly and the symptoms may get worse over time or show no signs of significant improvement.
How the diagnosis is made
In order to make the correct diagnosis of this disease it is important to consult a neurologist, as in addition to assessing the symptoms it is also important to perform other diagnostic tests, such as cerebrospinal fluid analysis, magnetic resonance imaging or electroencephalogram to detect brain lesions that indicate the existence of autoimmune encephalitis.
Blood tests can also be done to determine if there are antibodies that can cause these types of changes. Some of the main autoantibodies are anti NMDAR, anti VGKC or anti GlyR, for example, specific to each type of encephalitis.
In addition, to investigate autoimmune encephalitis, the doctor also needs to rule out other more frequent causes of brain inflammation, such as viral or bacterial infections.
How the treatment is done
Treatment for autoimmune encephalitis is started with one or more of the following types of treatment:
- Use of corticosteroids, such as Prednisone or Hydrocortisone, to decrease the response of the immune system; Use of immunosuppressants, such as Rituximab or Cyclophosphamide, for a more potent reduction in the action of the immune system; Plasmapheresis, to filter the blood and remove excess antibodies that are causing the disease; Immunoglobulin injections, as it replaces the binding of harmful antibodies to brain cells; Removal of tumors that may be the source of the antibodies that cause encephalitis.
Medications may also be needed to reduce symptoms such as anticonvulsants or anxiolytics, for example.
In addition, it is important that the person affected by autoimmune encephalitis undergoes rehabilitation, and there may be a need for physical therapy, occupational therapy or psychiatric monitoring, to reduce symptoms and reduce possible sequelae.
What can cause encephalitis
The specific cause of this type of encephalitis is not yet known, and in many cases it appears in healthy people. It is also believed that autoantibodies can originate after some types of infection, by bacteria or viruses, which can lead to 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, which is called paraneoplastic syndrome. Therefore, in the presence of an autoimmune encephalitis, it is necessary to investigate the presence of cancer.
