Don’t Be Left Behind. Keep Up With THE HERD!
Selected Highlighted News in the field of Autoimmune
Encephalitis October 2020 2nd edition
In this Issue~
* Announcements: National Family Caregiver Month, Survey on the impact of COVID-19 & autoimmune diseases, AE Warrior Store, AE Trivia Playing Cards
*Children’s Corner: Halloween themed cognitive exercises worksheets, Ocean Facts & Activities for Homeschooling
*Most Popular Visual of the Month: IAES First Aid Tool Kit, Algorithm Treatment for AE, Stop. Someone in this house has a Weak Immune System poster
*COVID-19’s Impact on the AE Community: Frequent neurologic manifestations and encephalopathy‐associated morbidity in Covid‐19 patients, Autoimmune Encephalitis Presenting with Acute Excited Catatonia in a 40-Year-Old Male Patient with Covid-19
*Most Popular Download: Resting on a Flare Day
*Featured AE Articles: Collaborating for Best Outcomes for Patients With Autoimmune Encephalitis – Video included, Therapy Approved for Rare Neurological Autoimmune Disorder
*Clinician’s Corner: Psychiatric Symptoms in anti-GAD associated Limbic Encephalitis in Adults: A Systematic Review
*COVID-19 Clinician’s Corner: COVID-19: dealing with a potential risk factor for chronic neurological disorders
*Open Access: The Road to Recovery: A Pilot Study of Driving Behaviors Following Antibody-Mediated Encephalitis
National Family Caregiver Month – November 2020
November is National Caregiver’s Month. IAES is encouraging AE patients (i.e. AE Warriors) to send in written submissions sharing how much you appreciate your caregiver and what their support means to you to be featured in a special IAES Blog in ‘Tribute to Our Caregivers’.
Help us shine a light on how much we appreciate our caregivers for the dedication and sacrifice they selflessly give 24/7.
Caregivers, we would like to hear from you too. What is your daily life like? What worries and concerns you? What would you like to share with the public about finding your life upended by AE that you found yourself thrust into a caregiver role? What you have to say is an important window into the daily lives of the families we serve and a vital part of raising awareness of AE and the needs of all members of the family. If you would like your submission to be anonymous, just let us know.
E-mail your submission to Barbara Layt Vujaklija at email@example.com with the ‘Caregiver Tribute’ in the regarding line. We will do the editing and put them together.
AE patients would not enjoy the lives we have or make as much progress as we do if not for those who care for us and love us. Join us in singing their praise and raising your voice for our unsung heroes, our caregivers.
Survey: Emotional, Social, and Physical Impact of COVID-19 on the Autoimmune Disease Community
Thank you for participating in my study about the emotional, social, and physical impact of COVID-19 on the Autoimmune Disease community and how patients attempt to cope with their disease. My name is Scott Weitman and I am a 17-year-old high school student living with an autoimmune disease called alopecia areata. Alopecia areata causes me to lose my hair and I was devastated by being a student with no hair.
The goal of my survey-based project is to analyze the emotional, social, and physical impact of COVID-19 on autoimmune disease patients as well as identifying effective coping strategies for people living with an autoimmune disease.
Important information to know before beginning the survey:
-The purpose of this study is to:
-gain insight into the emotional, social, and the physical impact of COVID-19 on autoimmune diseases.
-gain insight into how people attempt to cope with their autoimmune disease.
-share effective coping strategies with people struggling with an autoimmune disease.
-The survey will take approximately 10 minutes to complete.
-The survey is for anyone above the age of 7 years old.
-If the participant is younger than 18 years old they have to have parental consent.
-An asterisk* means that the question is required.
Raise Awareness by Shopping at the AE Warrior Store
IAES has designed several 3-ply masks that alert the public to the fact that you have AE and are at high risk of COVID-19 infection. In order to add a level of additional protection, we have designed a hat and 2 sided t-shirts with the ‘high risk’ graphic on the front and the message ‘If you can read this, you are too close”. Any family member or loved one can wear these to signal ‘high risk’ to COVID-19 infection. The goal is that we assist in keeping you and your family safe.
Visit our AE Warrior store to see a variety of products designed to raise AE awareness and support research.
The proceeds of your purchase will immediately support autoimmune encephalitis patients, caregivers, and families who are walking this difficult journey. Proceeds also go to support research.
AE Trivia Playing Cards
The perfect companion for patients, Caregivers & Therapist
Created by IAES and in collaboration with Josep Dalmau, M.D., Ph.D. (The World’s leading expert on AE). This deck answers 52 of the most commonly asked questions about AE and doubles as a rehabilitation tool. Increase your knowledge and become a strong advocate quickly and easily with AE trivia cards.
We appreciate the National Organization of Rare Diseases’ (NORD) enthusiastic support in recommending this groundbreaking product.
Children’s Corner (Students & Parents)
Halloween Themed Cognitive Exercise Worksheets for Rehabilitation
Here’s a fun way to engage your AE Warriors with cognitive exercises for improving their memory, executive
functioning, reasoning, and attention, among others.
Get in the Spirit with these 5 Halloween themed worksheets designed with children in mind (adults can still benefit from using them as well).
For more information and exercises for AE Warriors of all ages visit IAES’ website by clicking the tab below.
Ocean facts and Activities for Homeschooling
2020 has been a time for patience and adjustments to everyone around the globe due to COVID-19. Many of our AE families are managing work and homeschooling simultaneously. To assist you through these challenges we have put together a variety of resources you can easily access on our website.
Here is an oceanography guide for kids with fun activities and facts about marine life that is sure to be a favorite with elementary school AE Warriors.
You’ll find this resource and many other helpful resources on IAES’ #StrongerTogether website page.
Most Popular Download
The IAES First Aid Tool Kit
The IAES “First Aid Tool Kit”
Below is a direct link to other AE Fact Sheets and Handouts.
Algorithm for the Treatment of Autoimmune Encephalitis
Poster: Stop Someone in This House Has a Weak Immune System
COVID-19’s impact on the AE Community
Frequent neurologic manifestations and encephalopathy‐associated morbidity in Covid‐19 patients
This study highlights the high frequency and range of neurologic manifestations, which occurred in more than four-fifths of Covid‐19 patients hospitalized in our hospital network system. These results expand findings of neurologic manifestations in 36.4% of hospitalized Covid‐19 patients in China and 57.4% in Europe, albeit with increased prevalence in our US cohort.
The fact that any neurologic manifestations as a whole were more likely to occur in younger people is surprising, and could potentially be explained by greater clinical emphasis on the risk of respiratory failure than other symptoms in older patients. Alternatively, early neurologic manifestations such as myalgia, headache, or dizziness may have prompted earlier medical care. In contrast, encephalopathy was more frequent in older patients. Risk factors for encephalopathy also included severe Covid‐19 disease and a history of any neurological disorder or chronic kidney disease. This is consistent with recent literature identifying higher rates of mortality in Covid‐19 patients with pre‐existing chronic neurological disorders.
The increased morbidity and mortality associated with encephalopathy, independent of respiratory severity, parallels previous literature in sepsis‐associated encephalopathy and delirium‐associated mortality, and emphasizes its relevance in Covid‐19. We also found that encephalopathy in Covid‐19 was associated with triple the hospital length of stay. Broad recognition and screening for encephalopathy as a contributor to disease severity in Covid‐19 may have utility in resource allocation and the potential to improve patient outcomes.
Autoimmune Encephalitis Presenting with Acute Excited Catatonia in a 40-Year-Old Male Patient with Covid-19
This case raises the possibility that this may be a novel form of autoimmune encephalitis induced by infection with SARS-CoV-2.
Acute malignant catatonia with autonomic instability developed in a previously healthy man. CT and MRI were normal, EEG showed slowing and cerebrospinal fluid showed a subtle indication of inflammation. 18F-FDG-PET conveyed high bilateral uptake in the striatum. Antibody testing revealed antibodies attacking healthy brain cells in the hippocampus, thalamus, striatum, and cortex. Early treatment with plasmapheresis and corticosteroid reversed disease progression and may have prevented large-scale neurological damage.
(Note: This article is a preprint and has not been peer-reviewed [what does this mean?]. It reports new medical research that has yet to be evaluated and so should not be used to guide clinical practice.)
Most Popular Visual~
Resting on a Flare Day
Featured AE Articles~
Collaborating for Best Outcomes for Patients With Autoimmune Encephalitis – Video included
Therapy Approved for Rare Neurological Autoimmune Disorder
Some neurologists specializing in autoimmune neurology have told IAES that they believe this treatment might be an option for some AE patients.
Another treatment for certain patients with the rare autoimmune disease neuromyelitis optica spectrum disorder (NMOSD) has received FDA approval.
Satralizumab-mwge, marketed as Enspryng, was approved for adults with NMOSD who have antibodies against the aquaporin 4 (AQP4) protein. Binding of the antibodies with AQP4 activates the immune system and results in elevated, inflammation-promoting levels of interleukin 6 in cerebrospinal fluid. Satralizumab-mwge blocks interleukin 6 signaling pathways.
According to the manufacturer, Roche, satralizumab-mwge is the first subcutaneous treatment for adults with NMOSD who have antibodies against AQP4 that can be self-administered or given with a caregiver’s help. The wholesale price is $190 000 annually, according to a Roche spokesperson.
Serious adverse events include an increased risk of infection or potential reactivation of hepatitis B or tuberculosis, elevated liver enzymes, and decreased neutrophil counts. Common adverse events include nasopharyngitis, headache, and upper respiratory tract infection.
Psychiatric Symptoms in anti-GAD associated Limbic Encephalitis in Adults: A Systematic Review
Anti Glutamic Acid Decarboxylase (GAD) antibodies have emerged as a cause of Limbic Encephalitis (LE).
Limbic encephalitis associated to anti-GAD antibodies has atypical clinical presentation with psychiatric features.
Median diagnostic delay appears delayed.
Patients with an association of neurological and psychiatric symptoms should be screened for anti-GAD antibodies.
Patients with anti-GAD LE can benefit from immunomodulatory treatment.
COVID-19 Clinician’s Corner
COVID-19: dealing with a potential risk factor for chronic neurological disorders
This brief narrative review summarized the mechanisms of CNS affection during SARS-CoV2 infection, which include different pathways and pathogenic cascades, concluding in chronic neuroinflammatory or neurodegenerative processes that typically underlie both common (PD and MS) or rare (narcolepsy) neurological diseases. In addition to direct neuronal injury, we also highlighted how SARS-CoV2 might have a role in the successive development of these chronic neurological disorders because of the activation of the systemic inflammatory response, favouring a culprit unbalance in the immune system or affecting other critical players of neurodegeneration and neuroinflammation, such as BBB integrity and gut-brain axis (Fig. 1).
Figure 1 – SARS-CoV2-induced mechanisms for neuropathogenicity. The scheme represents direct and indirect effects of COVID-19 that overlap with defined pathogenic mechanisms of common and rare chronic neurological disorders, suggesting its potential role as a risk factor.
The Road to Recovery: A Pilot Study of Driving Behaviors Following Antibody-Mediated Encephalitis
Many of us go through rehabilitation as we are recovering from AE and/or after the disease is gone. Often, we have to take a special driving test to be able to drive again. This article discusses driving after AE. Some helpful things I learned during my driving test were to leave more space between me and the car in front of me to allow for better reaction time. Also to wait once a light changed from red to green to make sure someone else wasn’t running through the light. I give myself plenty of time to get where I am going so I don’t feel rushed. I always make sure I know the directions. This study can help give caregivers and doctors an idea of when it is safe to drive and what things to look for to ensure safe driving.
When you shop Amazon Smiles and select IAES as the non-profit you want to support, Amazon will donate 5% of our purchases to the International Autoimmune Encephalitis Society.
The need for our services has increased exponentially. This simple act of kindness, will support the work we do and advance our ability to service the community.
Your donations are greatly appreciated. Every dollar raised allows us to raise awareness and personally help Patients, Families and Caregivers through their Journey with AE so that best outcomes may be reached. Your contribution to our mission will help save a life and improve the quality of lives for others. Be a part of the solution by supporting IAES.
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.