Abstract Details

Title Validation of Clinical, Radiographic, and Laboratory Screening Criteria for Autoimmune Encephalitis

Topic Autoimmune Neurology

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

Poster/Presentation
Number 9-003

Objective To validate clinical screening criteria for autoimmune encephalitis.

Background Autoimmune encephalitis (AIE) varies in clinical presentation and severity. Advancements in the detection of autoantibodies has decreased time to diagnosis and treatment initiation. There are clinical, radiographic, and CSF features which can improve pre-test probability; however, these have not been validated in large scale trials.

Design/Methods We have selected patients, at a single institute, who were tested for autoimmune encephalitis autoantibodies from December 2019 to January 2020, and March 2020. We utilized the following set of clinical criteria from Graus et al, 1 major criteria: subacute onset altered mental status, less than three months, 4 minor criteria: 1) new focal neurologic finding, 2) seizure (not explained by known seizure history), 3) CSF pleocytosis, and 4) abnormal MRI findings suggesting encephalitis. The presence of 1 major and 2 minor criteria suggests a possible diagnosis of AIE, while 1 major and 3 or more minor, suggest a probable diagnosis of AIE.

Results 129 patients were identified in both the inpatient (92, 71%) and outpatient (37, 29%) setting, average age 47 years old, 68 (53%) were Female. Of the major criteria, 58 (45%) had subacute onset of altered mental status, and 17 (13%) patients had less than 3 months duration. Of the minor criteria, 88 (68%) patients presented with a new focal neurological finding, 23 (18%) with new onset seizures, 5 (4%) had CSF pleocytosis, and 12 (9%) had an abnormal MRI suggesting encephalitis. No statistically significant association was seen between the presence of major (P=0.32) or minor (P=0.81) criteria and a positive autoimmune encephalitis panel.

Conclusions Currently used clinical screening criteria for AIE seem to be poorly correlated to positivity of AIE autoantibody panel. Further studies are needed to define the clinical utility and correlation of AIE autoantibody panel.

Authors/Disclosures
Daniela R. Galluzzo, MD (Yale New Haven Hospital) PRESENTER	Dr. Galluzzo has nothing to disclose.
	No disclosure on file
Kristina Maselli, MD (Montefiore Headache Center)	Dr. Maselli has nothing to disclose.
Sydney Moseley, MD (Sydney Moseley)	Dr. Moseley has nothing to disclose.
Yarden Bornovski, MD (Westchester Medical Center)	Dr. Bornovski has nothing to disclose.
Jin Li, MD, PhD, FAAN	Dr. Li has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Abbvie. Dr. Li has a non-compensated relationship as a member, woman leadership committee with AAN that is relevant to AAN interests or activities.

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