Paraneoplastic Autoimmune Encephalitis

UCB sponsors the 2024 Speaker Series celebrating Autoimmune Encephalitis Awareness Month.
Hesham Abboud, MD, PhD is the Director of the Multiple Sclerosis and Neuroimmunology Program at University Hospitals Cleveland Medical Center and a staff neurologist in the Parkinson’s & Movement Disorders Center. He is an Assistant Professor of Neurology at Case Western Reserve University School of Medicine.
This is an engaging presentation with helpful visuals throughout that allow both clinician and family member, or patient to follow along and absorb a complex topic with ease. If you are a patient with a diagnosis of autoimmune encephalitis, paraneoplastic or not, you will gain a greater understanding of the disease as Dr. Abboud has a distinct talent as an educator.
Dr. Abboud begins by defining Paraneoplastic AE, which is thought to impact 1 in 300 cancer patients. By reviewing how the clinician arrives at the diagnosis, he reviews several MRIs showing grey matter and white matter-focused examples explaining that inflammation in paraneoplastic cases is caused by T-cells, not the antibody. B cells in this situation do not cause harm. The difference between intracellular and extracellular antibodies is illustrated with clear slides. Specific treatments are utilized in these cases. Dr. Abboud explains why some common treatments in non-paraneoplastic cases are not required, such as Rituxan and plasma exchange. 3 cases, including video footage, are presented illustrating the wide spectrum of presentations and challenges treatment decisions clinicians are faced with to ensure the best possible outcomes.
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Autoimmune Encephalitis is a group of inflammatory brain diseases characterized by prominent neuropsychiatric symptoms. These patients are often believed to have psychiatric presentations, but they do NOT. Common clinical features include a change in behavior, psychosis, seizures, memory, and cognitive deficits, abnormal movements, dysautonomia, and a decreased level of consciousness. Psychiatrists and Emergency Room Physicians are often the first medical professionals who see these patients. Clinicians must consider the possibility of an autoantibody-related etiology and become familiar with the red flags suggestive of synaptic autoimmunity as the underlying cause in all cases of first-onset, out-of-the-blue psychosis. A high level of suspicion is necessary as autoimmune encephalitis is treatable with immunotherapy. Firm evidence shows that earlier recognition and treatment lead to improved outcomes. It is important to note, that the disorder is refractory to antipsychotics; indeed, antipsychotic agents make affected patients much worse, even to the point of developing something akin to neuroleptic malignant syndrome.
The International Autoimmune Encephalitis, (IAES), is a registered 501 C 3 non-profit and is the only Family/Patient-centered organization for people diagnosed with Autoimmune Encephalitis. Leading with integrity, IAES strives to advance services, education, increased awareness, and research for this group of diseases. IAES provides science-based information backed by trusted medical experts in the field of autoimmune neurology. IAES is the only organization that provides all-inclusive services from diagnosis to recovery and the many challenges experienced in that journey.