Autoimmune encephalitis mimicking sporadic Creutzfeldt-Jakob disease: A retrospective study

J Neuroimmunol. 2016 Jun 15:295-296:1-8. doi: 10.1016/j.jneuroim.2016.03.012. Epub 2016 Apr 2.

Abstract

Autoimmune encephalitis associated with anti-voltage-gated potassium channel antibodies are most likely to be misdiagnosed as sporadic Creutzfeldt-Jakob disease (sCJD). Our goal was to delineate patients who were initially suspected to have CJD but were later found to have AE. We performed a retrospective clinical review of cases of individuals and made a comparison between groups of patients diagnosed with sCJD and AE. Patients who had rapidly progressing dementia and focal neurological impairment, such as aphasia, gait disturbance, visual disturbance, and depression, at onset were diagnosed with sCJD, whereas epilepsy, hyponatremia and dysautonomia were strong hints for AE. Fluoroscope-positron emission tomography (PET) of patients with AE revealed variable metabolism and normative and long-term immunosuppression were less likely to relapse.

Keywords: Cerebral PET; Immunotherapy; Myoclonus; VGKC autoimmune encephalitis.

MeSH terms

  • Aged
  • Creutzfeldt-Jakob Syndrome / diagnosis
  • Creutzfeldt-Jakob Syndrome / immunology
  • Creutzfeldt-Jakob Syndrome / physiopathology*
  • Diagnosis, Differential
  • Electroencephalography
  • Female
  • Humans
  • Image Processing, Computer-Assisted
  • Magnetic Resonance Imaging
  • Male
  • Membrane Proteins / immunology
  • Membrane Proteins / metabolism
  • Middle Aged
  • Nerve Tissue Proteins / immunology
  • Nerve Tissue Proteins / metabolism
  • Polyendocrinopathies, Autoimmune / diagnosis*
  • Polyendocrinopathies, Autoimmune / physiopathology
  • Positron-Emission Tomography
  • Retrospective Studies
  • Severity of Illness Index

Substances

  • CNTNAP2 protein, human
  • Membrane Proteins
  • Nerve Tissue Proteins

Supplementary concepts

  • Autoimmune enteropathy