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Abstract Details

The Autoimmune Encephalitis: Historical Overview
Research Methodology, Education, and History
History of Neurology Posters (7:00 AM-5:00 PM)
003
Our knowledge of autoimmune encephalitis began as early as 1938, when Brouwer and Biemond reported the first neurologic paraneoplastic syndrome in a patient with cerebellar degeneration and ovarian cancer. Brouwer and Biemond postulated that cerebellar degeneration was associated with cancer located elsewhere in the body and small in size.

To review the historical evolution of key concepts in the field of autoimmune encephalitis over the last two centuries.

Review of the historical publications related to paraneoplastic encephalitis and autoimmune encephalitis. 

In 1961, Russell proposed a mechanism of neurological injury in paraneoplastic syndromes to the formation of autoantibodies triggered by exposure of the immune system to certain types of cancer. Later in 1968, Corsellis and colleagues described a few patients with lung cancer who also developed neurologic symptoms - memory loss, neuropsychiatric disturbances, and seizures - without evidence of brain metastases. At autopsy, the investigators found significant inflammatory involvement of limbic areas and termed this new entity ‘limbic encephalitis’. In 1981, John Newsom-Davis was the first to establish an autoimmune mechanism for paraneoplastic neurological disorder by successfully treating three cases of Lambert-Eaton myasthenic syndrome with plasma exchange and immunosuppression with steroids. In 1990, Posner compared serum and CSF profiles of 18 patients before and after plasmapheresis, concluding that autoantibodies in paraneoplastic syndrome may be synthesized in the CSF. In 2001, Ligouri et al. and Buckley et al. separately presented case reports of two individuals with reversible limbic encephalitis associated with voltage-gated potassium channels (VGKC) antibodies. In 2005 Dalmau and colleagues described encephalitis associated with NMDA receptor autoantibodies in 12 patients with NMDA encephalitis.

The 20th century discoveries in pathophysiology behind autoimmune encephalitis resulted in the evolution of emerging entity within the field of neurology characterized by a growing number of antibodies discovered in last two decades.

Authors/Disclosures
Arpan Patel, MBBS (University of Kansas Medical Center)
PRESENTER
Dr. Patel has nothing to disclose.
Prateeka Koul, MD Dr. Koul has nothing to disclose.
Fred A. Lado, MD (Neuroscience Institute of Northwell Health) Dr. Lado has a non-compensated relationship as a Board Member with American Epilepsy Society that is relevant to AAN interests or activities. Dr. Lado has a non-compensated relationship as a Officer with National Association of Epilepsy Centers that is relevant to AAN interests or activities.