
Don’t Be Left Behind. Keep Up With THE HERD!
Selected Highlighted News in the field of Autoimmune
Encephalitis July 2019 1st edition
In this Issue~
- Upcoming Events: Texas, London
- Most Popular Article of the Month: Systematic Review: Syndromes, Early Diagnosis, and Treatment in Autoimmune Encephalitis
- Most Popular IAES Printable Handout: Living with Brain Injury
- Most Shared Post: Dr. Suess on Autoimmune Encephalitis
- Most Listened to Podcast: Recognizing anti-NMDAr Encephalitis when a case comes to the ER
- Clinician’s Corner: Autoimmune Epilepsy
- Open Access Research: Research: Hippocampal network abnormalities explain amnesia after VGKCC-Ab related autoimmune limbic encephalitis


IAES is delighted to support the 2nd Annual Texas Children’s Hospital (TCH) Family Day of Strength event that will be held in Houston on July 27th from 11:30 to 5 pm. The group is led by Dr. Eyal Muscal.

Tue 16 Jul 2019 from 9:25 am to 17 Jul 2019 at 7:00 pm. Location: London, Royal Society of Medicine. IAES is pleased to be attending this event! Autoimmune encephalitis, presentations and management from Neurological, Psychiatric, and Neuropsychological perspectives.
Most Popular Article of the Month~

Systematic Review: Syndromes, Early Diagnosis, and Treatment in Autoimmune Encephalitis
This is a very nice systemic review of AE that includes antibody charts, treatments with dose and frequency and a nice description of how AE is diagnosed as well.
Most Liked and Shared IAES Post

Dr. Suess on Autoimmune Encephalitis
You have brains in your head, you most certainly do.
100 billion neurons are there, give or take one or two.
One rainy day when the weather was shoddy,
My immune system rebelled and made a strange antibody.
As quick as a shot from my head to my toes, my thinking and feeling went haywire to ‘anything goes’.
My seeing, my walking, my talking, MY WORD,what I heard, what I saw, what I thought was absurd!
That antibody doubled, it tri-multi-zooppled!
Making an army of friends ~ all uninvited~ who hitch rides on my neurons getting them over excited!
Zipping this way and that way around in my brain
those antibodies zapped me causing terrible pain.
My poor brain it was not feeling well. My poor brain felt insane and it started to swell!
To the Doctor I went (for my thinking was spent).
I got this test and that test and a Brain selfie too
As my Doctor, called another Doctor, who called another he knew.
They all came to see me, to try and figure out what was wrong in my head?
What was this fuss all about?
“Could it be something rare? Could it be something quite new?”
Came a voice from the doorway where all eyes suddenly flew.
It was Dr. Dalmau stopping in for a look
All the Doctors were quiet, as this man wrote the book.
“I agree when you say it is not meningitis, this patient has Autoimmune Encephalitis!
Most Popular Podcast
Dr. Carr discusses anti-NMDAr in this Case Study with the Aim to Educate Medical Practitioners about this ‘Must Know’ Diagnosis
Listen to Dr. David Carr present this episode of “Best Case Ever” about Anti-NMDA Receptor Encephalitis, a diagnosis that was only discovered in 2005, and has only recently been recognized by the Emergency Medicine community. Anti-NMDA Receptor Encephalitis may mimic a first presentation of schizophrenia or Neuraleptic Malignant Syndrome. It may present with seizure, altered mental status, autonomic instability or movement disorder in the absence of drug exposure. When you are faced with any of these presentations and no other diagnosis seems to fit, do an LP and send the CSF for anti-NMDA receptor antibodies. The time-sensitive treatment is IVIG and steroids. Anti-NMDA receptor Encephalitis is a must know diagnosis for all emergency medicine practitioners. Learn how to pick up this important diagnosis by listening to Dr. Carr.

Clinician’s Corner
Autoimmune Epilepsy
Autoimmune Epilepsy is a rapidly expanding field. Check out this review article discussing the latest advances, diagnostics and therapeutics.
Input on this paper from other an expert in the field, Dr. Sarosh Irani of Oxford was: “The main question is whether we should call this Autoimmune epilepsy/ seizures or Autoimmune Encephalitis? Some favor lumping, based on likely common pathophysiology. Others feel epilepsy/seizures helpfully signpost patient’s symptoms and aid rapid diagnosis.”

Hippocampal network abnormalities explain amnesia after VGKCC-Ab related autoimmune limbic encephalitis
Limbic encephalitis associated with antibodies to components of the voltage-gated potassium channel complex (VGKCC-Ab-LE) often leads to hippocampal atrophy and persistent memory impairment. Patients showed selective memory impairment.
Hippocampal network abnormalities explain amnesia after VGKCC-Ab related autoimmune limbic encephalitis
Our patients demonstrated amnesia with no deficits in other domains, in contrast to other reports. This is consistent with findings that VGKCC-Ab-LE patients often make substantial recovery post-immunotherapy in executive function, yet present with residual amnesia. The focal nature of our patients’ impairment is of importance in the interpretation of their brain abnormalities.
Patients showed striking preservation of visual recognition memory despite profound impairment of verbal and non-verbal recall and verbal recognition memory. There is a long-standing debate about whether recall and recognition memory rely on dissociable neurocognitive processes.
Conclusion VGKCC-Ab-LE results in persistent isolated memory impairment. Patients have hippocampal atrophy with further reduced mediodorsal thalamic and posteromedial cortical volumes. Crucially, reduced functional connectivity of remaining hippocampal tissue correlates more closely with memory function than does regional atrophy.

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International Autoimmune Encephalitis Society (IAES) is a Family/Patient centered organization that assists members from getting a diagnosis through to recovery and the many challenges experienced in their journey.
Driven by the knowledge that “Education is Power”, Int’l AE Society manages an educational support group for patients diagnosed with Autoimmune Encephalitis and their loved ones on Face Book, empowering them to be strong self-advocates and advocates that will lead them to best outcomes and recovery. We are the premiere organization leading in these vital roles.