Aim -To study the clinical profile, management and outcome of the patients presenting with subacute and rapidly progressive cognitive and behavior changes.

The cognitive impairment due to autoimmune etiology is being recognized as potentially treatable and reversible cause of dementia in recent times. The autoimmune cause accounts for 20% of dementia cases in young patients. Early diagnosis and prompt treatment is mandatory to optimize outcome and reduce the risk of Autoimmune dementia.

A prospective study - Duration 2014 -2019.  

Inclusion Criteria -  All the patients presenting with sub-acute onset and rapidly progressive cognitive and behavior decline. 

Detailed clinical evaluation included assessment of neurological, cognitive and behavioral functions. Investigation for the possible etiology (Hematological, Biochemical, Endocrine and metabolic screening, CSF examination, neuronal specific and paraneoplastic antibodies). Neuroimaging was performed in all patients while whole body PET scan was done in selected cases. Patients were treated accordingly with steroids and immunomodulators (IVIG) along with symptomatic treatment and followed up for outcome.

32 patients were included after fulfilling inclusion criteria.  The patients are classified into following categories . VGKC – 5 pts, NMDR- 9, Hashimoto’s 5, Paraneoplastic -5, Neurosarcoid, Werneck’s and MOG one patient each. On presentation twelve patient had altered sensorium . Abnormal involuntary movement was present in 6 patients diagnosed NMDR. 4 patient had myoclonus. Generalized Seizure were present in 15 patients. Hyper religiousness was present in 3 patients. Malignancy was found in two patients of paraneoplastic.Methylprednisolone and IVIG was give. 

VGKC and Hashimoto’s patients have better prognosis. 3 NMDR patients have extrapyramidal sequalae. 3 out of 5 patients of paraneoplastic succumbed to illness. All other patients had minimal behavioral problems and favorable outcome.