Analisys of clinical characteristics of autoimmune encephalitis

Objective To investigate the clinical and imaging features of autoimmune encephalitis. Methods A total of 19 patients with autoimmune encephalitis diagnosed in the Affiliated Hospital of Xuzhou Medical University from June 2016 to October 2019 were collected, and their clinical manifestations, cerebrospinal fluid (CSF) examination, imaging manifestations, electroencephalography (EEG) examination and treatment prognosis were analyzed retrospectively. Results Among the 19 patients, 14 were male and 5 were female, aged 18 to 68 years, with an average age of (42.1 ± 16.0) years. The clinical manifestations were epilepsy in 14 cases, mental and behavioral disorders in 10 cases, cognitive disorders in 9 cases, decreased consciousness or coma in 4 cases, speech disorders in 3 cases, autonomic nervous dysfunction in 3 cases, sleep disorders in 3 cases, diarrhea in 1 case,hyponatremia in 1 case. CSF examination showed that there were 18 cases with increased leukocyte number, 11 cases with increased protein, 11 cases with increased immunoglobulin IgG, and 7 cases with increased lymphocyte in liquid-based cytology. Imaging examination results: the main findings of MRI of the brain were that T2 weighted image (T2WI) and FLAIR sequence of frontal lobe, temporal lobe, hippocampus and insular lobe showed high signal, while diffusion-weighted image (DWI) showed high signal in some patients, while enhanced scan with enhancement was rare. There were 6 cases with normal EEG, 5 cases with mild abnormality, 4 cases with moderate abnormality and 1 case with severe abnormality. Treatment prognosis: after using glucocorticoid, immunoglobulin and other immunotherapy, the modified Rankin Scale (MRS) score of most patients was 1-3 points lower than that at the time of admission, 6 patients recovered completely and 1 patient gave up treatment. Conclusions The clinical manifestations of autoimmune encephalitis are complex and diverse. The possibility of autoimmune encephalitis should be considered if the patients are presented with acute orsubacute onset of epilepsy, mental and behavioral disorders, and cognitive disorders. It is necessary to improve the examination of cerebrospinal fluid and brain MRI, and start immunotherapy as early as possible.