Journal Article (Review Article)

DZNE-2020-07429

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Autoimmune encephalitis with psychosis: Warning signs, step-by-step diagnostics and treatment.

Steiner, J. (Corresponding author) ; Prüss, H.DZNE* ; Köhler, S. ; Frodl, T. ; Hasan, A. ; Falkai, P.

2018
Taylor & Francis Group Abingdon

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Please use a persistent id in citations: doi:10.1080/15622975.2018.1555376

Abstract: Despite intensive research, schizophrenia and schizoaffective disorders continue to be theoretical constructs that describe clinical syndromes and no pathophysiologically defined diseases. Moreover, there are no clear biomarkers at hand. Therefore, these diagnoses are still set up based on clinical ICD-10/DSM-5 criteria and the exclusion of alcohol-/drug-associated, systemic or other brain organic causes.Recently, autoimmune encephalitis with psychotic symptoms caused by specific antineuronal antibodies has been identified as a rare, but potentially treatable differential diagnosis. However, these inflammatory brain diseases are not reliably detected by our current routine diagnostic workup in psychiatry. This qualitative review provides structured diagnostic and therapeutic support for clinical practice.Disturbances of consciousness and orientation, catatonia, speech dysfunction, focal neurological signs, epileptic seizures/EEG abnormalities or autonomic dysfunction are warning signs in psychiatric patients which should always induce cerebrospinal fluid analysis with determination of antineuronal autoantibodies. Currently established immunotherapy strategies are summarised, taking into account international expert advice.Guided by clinical warning signs, our qualitative review enables rapid and reliable diagnosis of definite autoimmune encephalitis. This is of high relevance for the affected individuals, since early and sufficiently intense immunotherapy often leads to a good prognosis despite severe illness.

Keyword(s): Autoantibodies (MeSH) ; Encephalitis: cerebrospinal fluid (MeSH) ; Encephalitis: complications (MeSH) ; Encephalitis: diagnosis (MeSH) ; Encephalitis: therapy (MeSH) ; Hashimoto Disease: cerebrospinal fluid (MeSH) ; Hashimoto Disease: complications (MeSH) ; Hashimoto Disease: diagnosis (MeSH) ; Hashimoto Disease: therapy (MeSH) ; Humans (MeSH) ; Immunotherapy (MeSH) ; Psychotic Disorders: cerebrospinal fluid (MeSH) ; Psychotic Disorders: complications (MeSH) ; Psychotic Disorders: diagnosis (MeSH) ; Psychotic Disorders: therapy (MeSH)

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Contributing Institute(s):

1. Autoimmune Enzephalopathies (AG Prüß)

Research Program(s):

1. 342 - Disease Mechanisms and Model Systems (POF3-342) (POF3-342)

Appears in the scientific report 2018

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Database coverage:
; ; ; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; Current Contents - Life Sciences ; Ebsco Academic Search ; IF < 5 ; JCR ; Nationallizenz ; SCOPUS ; Web of Science Core Collection

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