Abstract Details

Title Residual Symptoms and Long-term Outcomes after All-Cause Autoimmune Encephalitis

Topic Autoimmune Neurology

Presentation(s) P5 - Poster Session 5 (11:45 AM-12:45 PM)

Poster/Presentation
Number 9-002

Objective To evaluate residual symptoms after all-cause autoimmune encephalitis in a real-life outpatient setting and compare long-term outcome measures. A secondary objective was to identify correlates of poor outcomes.

Background Residual symptoms and long-term outcomes after autoimmune encephalitis are understudied.

Design/Methods We conducted a retrospective analysis of patients referred to the Neuroimmunology clinic for evaluation of autoimmune encephalitis for whom standardized data were collected. We compared the prevalence of symptoms at the latest follow-up to presentation and calculated symptom improvement rates. We compared the Modified Rankin Scale (mRS) to the Clinical Assessment Scale for Autoimmune Encephalitis (CASE). Non-parametric Wilcoxon rank sum tests and Fisher’s exact tests were used to compare clinical attributes between patients with and without poor outcomes

Results We evaluated 54 patients between 2017-2021 of whom 33 met inclusion criteria (average age 47+/-20 years, 57% females, 55% seropositive). By latest follow-up, 94% improved compared to presentation but 6 patients (18%) had poor outcomes as defined by an mRS ≥3. The most common residual symptoms were cognitive and mood dysfunction. The highest improvement rates were in alertness and psychosis while the lowest were in motor function and ataxia. CASE had moderate correlation with mRS (r2=0.53 [95%CI:0.23,0.74, p=0.0015) but it captured more nuances than mRS at both presentation and follow-up. Older age and higher post-treatment CASE score correlated with poor outcomes.

Conclusions Most autoimmune encephalitis patients experience symptom improvement post-treatment. The CASE score was more representative of the wide symptomatic spectrum of autoimmune encephalitis and correlated with poor outcomes. However, CASE did not capture patients with dysautonomia, sleep dysfunction, or death. This study provides class IV evidence that age and post-treatment CASE score correlate with long-term outcome after all-cause autoimmune encephalitis.

Authors/Disclosures
Hesham A. Abboud, MD (University Hospitals Cleveland Medical Center) PRESENTER	Dr. Abboud has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. The institution of Dr. Abboud has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Genentech . Dr. Abboud has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion. Dr. Abboud has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Horizon. Dr. Abboud has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BMS. Dr. Abboud has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alpine Pharma. Dr. Abboud has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech. Dr. Abboud has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Horizon. Dr. Abboud has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Cycle Pharma. Dr. Abboud has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Axonics. Dr. Abboud has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutics. Dr. Abboud has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen. Dr. Abboud has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Genentech. Dr. Abboud has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for BMS. Dr. Abboud has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Horizon. Dr. Abboud has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for TG Therapeutics. The institution of Dr. Abboud has received research support from Genentech . The institution of Dr. Abboud has received research support from Novartis. The institution of Dr. Abboud has received research support from BMS. The institution of Dr. Abboud has received research support from Sanofi-Genzyme. The institution of Dr. Abboud has received research support from The Guthy-Jackson Charitable Foundation. The institution of Dr. Abboud has received research support from UCB. Dr. Abboud has received publishing royalties from a publication relating to health care.
Farren Briggs, PhD (University of Miami Miller School of Medicine)	The institution of Prof. Briggs has received research support from NIH.
Robin A. Buerki, MD, PhD (University of California, San Francisco)	No disclosure on file
Mohamed Elkasaby, MD	Dr. Elkasaby has nothing to disclose.
Guadalupe Fernandez-Baca Vaca, MD	Dr. Fernandez-Baca Vaca has nothing to disclose.
Neel Fotedar, MD (University Hospitals Cleveland Medical Center)	Dr. Fotedar has received research support from NINDS.
Christopher D. Geiger, MD, FAAN (University Hospitals-Cleveland Medical Center)	Dr. Geiger has nothing to disclose.
	No disclosure on file
	No disclosure on file
Alexander Lewis, DO (University Hospitals Cleveland Medical Center)	Dr. Lewis has nothing to disclose.
Alessandro Serra, MD (University Hospitals Cleveland Medical Center)	Dr. Serra has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Biogen Idec. Dr. Serra has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Bristol Myers Squibb.
Rajeet Shrestha	Rajeet Shrestha has received personal compensation in the range of $500-$4,999 for serving as a Speaker for CME program with Clinical Care Options .
	No disclosure on file
Aasef Shaikh, MD	Dr. Shaikh has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Acorda.

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