Diagnostic and Therapeutic Approach to Autoimmune Neurologic Disorders

Semin Neurol. 2018 Jun;38(3):392-402. doi: 10.1055/s-0038-1660819. Epub 2018 Jul 16.

Abstract

The field of autoimmune neurology is evolving rapidly. The discovery of autoantibodies that target neural antigens has expanded swiftly in the last decade. Recognition of the clinical syndromes associated with autoimmune neurologic disorders, and our understanding of the pathophysiology, has progressed significantly. Radiographic, electrophysiological, and laboratory testing (particularly neural autoantibody testing) are fundamental in the diagnosis of autoimmune neurological disorders and in the exclusion of mimics. Furthermore, investigations may serve as a baseline from which objective assessment of improvement or detection of relapse can be made. These disorders can be associated with underlying neoplasms, and screening for malignancy is an essential component of the investigations. Early diagnosis and prompt initiation of immunotherapy can improve neurologic function. The use of immunotherapy, however, can be associated with diverse side effects, and careful monitoring is crucial to prevent complications. Herein the authors address the diagnostic and treatment approach of autoimmune neurologic disorders, with particular focus on antibody-mediated neurologic autoimmunity.

Publication types

  • Review

MeSH terms

  • Autoantibodies / immunology*
  • Autoimmune Diseases of the Nervous System* / diagnosis
  • Autoimmune Diseases of the Nervous System* / drug therapy
  • Autoimmune Diseases of the Nervous System* / immunology
  • Autoimmune Diseases* / complications
  • Autoimmune Diseases* / diagnosis
  • Autoimmune Diseases* / therapy
  • Encephalitis / diagnosis
  • Encephalitis / therapy
  • Hashimoto Disease / diagnosis
  • Hashimoto Disease / therapy
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Immunotherapy*

Substances

  • Autoantibodies
  • Immunosuppressive Agents

Supplementary concepts

  • Hashimoto's encephalitis