TY - CHAP M1 - Book, Section TI - Noninfectious Encephalitis A1 - Rubin, Daniel B. A1 - Vaitkevicius, Henrikas A2 - Schmidt, Gregory A. A2 - Kress, John P. A2 - Douglas, Ivor S. PY - 2023 T2 - Hall, Schmidt and Wood’s Principles of Critical Care, 5th Edition AB - KEY POINTSAutoimmune diseases of the central nervous system (CNS) can cause profound neurologic dysfunction, but if treated promptly many have a favorable prognosis.Patients may manifest a classic clinical syndrome such as limbic or brainstem encephalitis but commonly present with a nonspecific decline in functional status and level of arousal.Clinical features suggesting noninfectious encephalitis include subacute onset, younger age, seizure, personality change, history of cancer, and mild/moderate cerebrospinal fluid (CSF) pleocytosis.Diagnostic workup includes MRI, lumbar puncture, antibody studies, EEG, and, in certain indications, advanced imaging studies including FDG-PET.Definitive diagnosis often takes weeks during which irreversible parenchymal injury may occur. To optimize long-term neurologic outcome, empiric treatment should be initiated as soon as alternative diagnoses have been reasonably excluded.Empiric treatment with immunomodulatory therapy should be directed at the presumed mechanism of immune dysfunction and can be tailored as specific diagnostic studies are resulted. SN - PB - McGraw Hill CY - New York, NY Y2 - 2023/12/07 UR - accessanesthesiology.mhmedical.com/content.aspx?aid=1201807792 ER -