RT Book, Section
A1 Rubin, Daniel B.
A1 Vaitkevicius, Henrikas
A2 Schmidt, Gregory A.
A2 Kress, John P.
A2 Douglas, Ivor S.
SR Print(0)
ID 1201807792
T1 Noninfectious Encephalitis
T2 Hall, Schmidt and Wood’s Principles of Critical Care, 5<sup>th</sup> Edition
YR 2023
FD 2023
PB McGraw Hill
PP New York, NY
SN 9781264264353
LK accessanesthesiology.mhmedical.com/content.aspx?aid=1201807792
RD 2023/12/02
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.