Download PDF
Fortschr Neurol Psychiatr 2013; 81(9): 523-538
DOI: 10.1055/s-0033-1350145
Fort- und Weiterbildung
© Georg Thieme Verlag KG Stuttgart · New York

Autoimmune Enzephalitiden

Autoimmune Encephalitis
F. Leypoldt
Further Information

Publication History

Publication Date:
28 August 2013 (online)

    Permissions and Reprints

Lernziele

Dieser Fortbildungsartikel gibt einen Überblick über das in den letzten Jahren rapide wachsende Wissen um autoimmune und insb. antikörpervermittelte Enzephalitiden. Der Artikel rekapituliert bekanntes und bietet neues Wissen zu typischen klinischen Syndromen, der Interpretation von Bild- und Laborbefunden und der rationalen Antikörperdiagnostik. Ein Schwerpunkt liegt auch auf Therapie und Verlaufskontrolle von Enzephalitiden. Dem Leser wird ein kurzer Überblick über die Systematik und die Pathophysiologie geboten.

 

  • Literatur

  • 1 Granerod J, Ambrose HE, Davies NW et al. UK Health Protection Agency (HPA) Aetiology of Encephalitis Study Group: Causes of encephalitis and differences in their clinical presentations in England: a multicentre, population-based prospective study. Lancet Infect Dis 2010; 10: 835-844
    CrossrefPubMedGoogle Scholar
  • 2 Noseworthy JH, Lucchinetti C, Rodriguez M et al. Multiple sclerosis. N Engl J Med 2000; 343: 938-952
    CrossrefPubMedGoogle Scholar
  • 3 Bien CG, Vincent A, Barnett MH et al. Immunopathology of autoantibody-associated encephalitides: clues for pathogenesis. Brain 2012; 135: 1622-1638
    CrossrefPubMedGoogle Scholar
  • 4 Hughes EG, Peng X, Gleichman AJ et al. Cellular and synaptic mechanisms of anti-NMDA receptor encephalitis. J Neurosci 2010; 30: 5866-5875
    CrossrefPubMedGoogle Scholar
  • 5 Lancaster E, Lai M, Peng X et al. Antibodies to the GABAB receptor in limbic encephalitis with seizures: case series and characterisation of the antigen. The Lancet Neurology 2010; 9: 67-76
    CrossrefPubMedGoogle Scholar
  • 6 Dalmau J, Gleichman AJ, Hughes EG et al. Anti-NMDA-receptor encephalitis: case series and analysis of the effects of antibodies. Lancet Neurol 2008; 7: 1091-1098
    CrossrefPubMedGoogle Scholar
  • 7 Rosenfeld MR, Dalmau J. Anti-NMDA-Receptor Encephalitis and Other Synaptic Autoimmune Disorders. Curr Treat Options Neurol 2011; 13: 324-332
    CrossrefPubMedGoogle Scholar
  • 8 Brilot F, Dale RC, Selter RC et al. Antibodies to native myelin oligodendrocyte glycoprotein in children with inflammatory demyelinating central nervous system disease. Ann Neurol 2009; 66: 833-842
    CrossrefPubMedGoogle Scholar
  • 9 Giometto B, Grisold W, Vitaliani R et al. Paraneoplastic neurologic syndrome in the PNS Euronetwork database: a European study from 20 centers. Arch Neurol 2010; 67: 330-335
    CrossrefPubMedGoogle Scholar
  • 10 Graus F, Cordon-Cardo C, Posner J. Neuronal antinuclear antibody in sensory neuronopathy from lung cancer. Neurology 1985; 35: 538-543
    CrossrefPubMedGoogle Scholar
  • 11 Prüss H, Dalmau J, Harms L et al. Retrospective analysis of NMDA receptor antibodies in encephalitis of unknown origin. Neurology 2010; 75: 1735-1739
    CrossrefPubMedGoogle Scholar
  • 12 Dalmau J, Lancaster E, Martinez-Hernandez E et al. Clinical experience and laboratory investigations in patients with anti-NMDAR encephalitis. Lancet Neurol 2011; 10: 63-74
    Google Scholar
  • 13 Irani SR, Bera K, Waters P et al. N-methyl-D-aspartate antibody encephalitis: temporal progression of clinical and paraclinical observations in a predominantly non-paraneoplastic disorder of both sexes. Brain 2010; 133: 1655-1667
    CrossrefPubMedGoogle Scholar
  • 14 Kleinig TJ, Thompson PD, Matar W et al. The distinctive movement disorder of ovarian teratoma-associated encephalitis. Mov Disord 2008; 23: 1256-1261
    CrossrefPubMedGoogle Scholar
  • 15 Lai M, Huijbers MGM, Lancaster E et al. Investigation of LGI1 as the antigen in limbic encephalitis previously attributed to potassium channels: a case series. Lancet Neurol 2010; 9: 776-785
    CrossrefPubMedGoogle Scholar
  • 16 Lancaster E, Huijbers MGM, Bar V et al. Investigations of caspr2, an autoantigen of encephalitis and neuromyotonia. Ann Neurol 2011; 69: 303-311
    CrossrefPubMedGoogle Scholar
  • 17 Irani SR, Michell AW, Lang B et al. Faciobrachial dystonic seizures precede Lgi1 antibody limbic encephalitis. Ann Neurol 2011; 69: 892-900
    CrossrefPubMedGoogle Scholar
  • 18 Lai M, Hughes EG, Peng X et al. AMPA receptor antibodies in limbic encephalitis alter synaptic receptor location. Ann Neurol 2009; 65: 424-434
    CrossrefPubMedGoogle Scholar
  • 19 Boronat A, Sabater L, Saiz A et al. GABAB receptor antibodies in limbic encephalitis and anti-GAD-associated neurologic disorders. Neurology 2011; 76: 795-800
    CrossrefPubMedGoogle Scholar
  • 20 Pittock SJ, Lucchinetti CF, Parisi JE et al. Amphiphysin autoimmunity: paraneoplastic accompaniments. Ann Neurol 2005; 58: 96-107
    CrossrefPubMedGoogle Scholar
  • 21 Mas N, Saiz A, Leite MI et al. Antiglycine-receptor encephalomyelitis with rigidity. J Neurol Neurosurg Psychiatr 2010; 82: 1399-1401
    PubMedGoogle Scholar
  • 22 Piotrowicz A, Thümen A, Leite MI et al. A case of glycine-receptor antibody-associated encephalomyelitis with rigidity and myoclonus (PERM): clinical course, treatment and CSF findings. J Neurol 2011; 258: 2268-2270
    CrossrefPubMedGoogle Scholar
  • 23 Solimena M, Folli F, Aparisi R et al. Autoantibodies to GABA-ergic neurons and pancreatic beta cells in stiff-man syndrome. N Engl J Med 1990; 322: 1555-1560
    CrossrefPubMedGoogle Scholar
  • 24 Malter MP, Helmstaedter C, Urbach H et al. Antibodies to glutamic acid decarboxylase define a form of limbic encephalitis. Ann Neurol 2010; 67: 470-478
    CrossrefPubMedGoogle Scholar
  • 25 Bertsias GK, Ioannidis JPA, Aringer M et al. EULAR recommendations for the management of systemic lupus erythematosus with neuropsychiatric manifestations: report of a task force of the EULAR standing committee for clinical affairs. Ann Rheum Dis 2010; 69: 2074-2082
    CrossrefPubMedGoogle Scholar
  • 26 Lancaster E, Martinez-Hernandez E, Dalmau J. Encephalitis and antibodies to synaptic and neuronal cell surface proteins. Neurology 2011; 77: 179-189
    CrossrefPubMedGoogle Scholar
  • 27 Leypoldt F, Buchert R, Kleiter I et al. Fluorodeoxyglucose positron emission tomography in anti-N-methyl-D-aspartate receptor encephalitis: distinct pattern of disease. J Neurol Neurosurg Psychiatr 2012; 83: 681-686
    CrossrefPubMedGoogle Scholar
  • 28 Schmitt SE, Pargeon K, Frechette ES et al. Extreme delta brush: A unique EEG pattern in adults with anti-NMDA receptor encephalitis. Neurology 2012; 79: 1094-1100
    CrossrefPubMedGoogle Scholar
  • 29 Psimaras D, Carpentier A, Rossi C. CSF study in paraneoplastic syndromes. J Neurol Neurosurg Psychiatr 2010; 81: 42-45
    CrossrefPubMedGoogle Scholar
  • 30 Jarius S, Hoffmann L, Clover L et al. CSF findings in patients with voltage gated potassium channel antibody associated limbic encephalitis. J Neurol Sci 2008; 268: 74-77
    CrossrefPubMedGoogle Scholar
  • 31 Wandinger K-P, Saschenbrecker S, Stoecker W et al. Anti-NMDA-receptor encephalitis: A severe, multistage, treatable disorder presenting with psychosis. J Neuroimmunol 2011; 231: 86-91
    CrossrefPubMedGoogle Scholar
  • 32 Hadjivassiliou M, Alder SJ, Van Beek EJR et al. PET scan in clinically suspected paraneoplastic neurological syndromes: a 6-year prospective study in a regional neuroscience unit. Acta Neurologica Scandinavica 2009; 119: 186-193
    CrossrefPubMedGoogle Scholar
  • 33 Titulaer MJ, Soffietti R, Dalmau J et al. Screening for tumours in paraneoplastic syndromes: report of an EFNS task force. Eur J Neurol 2011; 18: 19-27
    CrossrefPubMedGoogle Scholar
  • 34 Graus F, Keime-Guibert F, Reñe R et al. Anti-Hu-associated paraneoplastic encephalomyelitis: analysis of 200 patients. Brain 2001; 124: 1138-1148
    CrossrefPubMedGoogle Scholar
  • 35 Hauser SL, Waubant E, Arnold DL et al. B-cell depletion with rituximab in relapsing-remitting multiple sclerosis. N Engl J Med 2008; 358: 676-688
    CrossrefPubMedGoogle Scholar
  • 36 Dalakas MC, Koffman B, Fujii M et al. A controlled study of intravenous immunoglobulin combined with prednisone in the treatment of IBM. Neurology 2001; 56: 323-327
    CrossrefPubMedGoogle Scholar
  • 37 Srivastava R, Aslam M, Kalluri SR et al. Potassium channel KIR4.1 as an immune target in multiple sclerosis. N Engl J Med 2012; 367: 115-123
    CrossrefPubMedGoogle Scholar