A clinical approach to diagnosis of autoimmune encephalitis.
A clinical approach to diagnosis of autoimmune encephalitis.
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DOI：
10.1016/s1474-4422(15)00401-9
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发表时间：
2016-04
期刊：
影响因子：
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通讯作者：
Dalmau J
中科院分区：
文献类型：
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作者：
Graus F;Titulaer MJ;Balu R;Benseler S;Bien CG;Cellucci T;Cortese I;Dale RC;Gelfand JM;Geschwind M;Glaser CA;Honnorat J;Höftberger R;Iizuka T;Irani SR;Lancaster E;Leypoldt F;Prüss H;Rae-Grant A;Reindl M;Rosenfeld MR;Rostásy K;Saiz A;Venkatesan A;Vincent A;Wandinger KP;Waters P;Dalmau J
脑炎是一种严重的脑部炎症性疾病，有许多可能的病因和复杂的鉴别诊断。在过去的10年里，自身免疫性脑炎研究的进展导致了新的综合征和生物标志物的发现，改变了对这些疾病的诊断方法。然而，现有的自身免疫性脑炎标准过于依赖于抗体检测和免疫治疗反应，这可能会延迟诊断。我们回顾了文献，并收集了一组专家的经验，目的是开发一种实用的、基于综合征的自身免疫性脑炎诊断方法，并为鉴别诊断提供指导。由于自身抗体测试结果和对治疗的反应在疾病发病时不可获得，我们基于大多数临床医生可获得的神经学评估和常规测试的初始诊断方法。通过逻辑鉴别诊断，可获得自身免疫性脑炎（可能、可能或确定）的证据水平，从而可及时进行免疫治疗。
Encephalitis is a severe inflammatory disorder of the brain with many possible causes and a complex differential diagnosis. Advances in autoimmune encephalitis research in the past 10 years have led to the identification of new syndromes and biomarkers that have transformed the diagnostic approach to these disorders. However, existing criteria for autoimmune encephalitis are too reliant on antibody testing and response to immunotherapy, which might delay the diagnosis. We reviewed the literature and gathered the experience of a team of experts with the aims of developing a practical, syndrome-based diagnostic approach to autoimmune encephalitis and providing guidelines to navigate through the differential diagnosis. Because autoantibody test results and response to therapy are not available at disease onset, we based the initial diagnostic approach on neurological assessment and conventional tests that are accessible to most clinicians. Through logical differential diagnosis, levels of evidence for autoimmune encephalitis (possible, probable, or definite) are achieved, which can lead to prompt immunotherapy.