Neurológia pre prax 6/2015

When to consider autoimmune etiology of central nervous system disorders in clinical practice

Autoimmune involvement of CNS can accompany systemic or organ specific autoimmune diseases or is a primary CNS affection. Clinically, autoimmune CNS disorders present with a variety of symptoms and there are distinctive neurological syndromes where autoimmune etiology should be suspected like limbic and NMDAR encephalitis, opsoclonus-myoclonus or stiff person syndrome. In other CNS disorders (myelitis, cerebellar ataxia, acute/subacute encephalopathy, status epilepticus and some types of epilepsy), autoimmune etiology should be considered if no other cause has been identified. Autoimmune etiology can be suggested by results of some investigations – autoantibodies, cerebrospinal fluid pleocytosis, specific brain or spinal cord MR findings, which should by always interpreted within the clinical context of an individual patient.

Keywords: autoimmune encephalitis, antineuronal antibodies, paraneoplastic syndromes, rheumatologic diseases.