Don’t Be Left Behind. Keep Up With THE HERD!
Selected Highlighted News in the field of Autoimmune Encephalitis~ October 2021 2nd Edition
In this Issue~
- *Announcements: The Well-Being Gratitude Journal, #AETuesdayTries & Growing Your Resilience Organizer, Health at a Glance Form for AE Warriors
- *Children’s Corner (for all ages): Use and Safety of Immunotherapeutic Management of N-Methyl-d-Aspartate Recptor Antibody Encephalitis: A Meta-analysis, 5 Halloween Worksheets
- *ABI Rehabilitation: Autoimmune Encephalitis Awareness Word Search
- *Helpful Tips for the AE Warrior: Homestead Exemptions Save on Property Taxes
- *Most Popular Visual Downloads: Autoimmune Encephalitis Halloween, Limbic Encephalitis
- *COVID-19’s Impact on the AE Community: Autoimmune Encephalitis Post-SARS-CoV-2 Infection: Case Frequency, Findings, and Outcomes
- *Featured AE Article: Long-term Cognitive Outcome in anti-NMDar Encephalitis
- *Clinician’s Corner: Successful treatment with immunoadsorption therapy in four patients with severe and refractory anti-N-methyl-D-aspartate receptor Encephalitis
- *COVID-19 Clinician’s Corner: Frequency of Neurologic Manifestations in COVID-19: A Systematic Review and Meta-analysis
- *Open Access: A Validated Nomogram That Predicts Prognosis of Autoimmune Encephalitis: A Multicenter Study in China
- *AE Trivia Cards: The single most important educational/rehabilitation tool for AE
- *AE Warrior Store: See our new AE Wingman and hat collections
- *Shop & Support IAES: Sign up for PayPal’s #GiveAtCheckOut and Amazon Smiles
Utilize the journal by challenging yourself to a 21-day commitment described. Spend two minutes a day scanning the world for three new things you’re grateful for over a 21-day period. We instinctively scan our environment for threats. This powerful exercise trains your brain to scan the world in a new pattern of scanning for positives. It’s the fastest way to teach optimism.
We are all capable of learning new behaviors and changing our brain patterns. Research has shown that a person with a low-level of pessimism on day 1 of this 21-day exercise will admit to feeling a low-level of optimism by day 21. When dealing with a life challenge as overwhelming as AE, it is important to take care of your mental health, feel supported in your ability to manage the crisis and feel empowered and truly resilient.
The Journal has a left-hand margin width for a 3-hole punch, so it can be inserted into a notebook. Coloring has been shown through research to mitigate symptoms of physical and emotional distress and is a recommended rehabilitation activity for AE patients. Color in the cover design to personalize your journal while relaxing into a pleasant past time.
Our new program “Tuesday Tries” addresses the emotional support and rehabilitation AE patients and caregivers require in recovering from Autoimmune Encephalitis by building your resilience. The program utilizes science-based exercises from the work of PERMA; Seligman, 2012.
IAES wants to foster your capacity in the belief that better days are ahead! “Tuesday Tries” is about practicing a strengths-based approach by “normalizing the try;” celebrating critical milestones in the recovery and care of AE patients and caregivers in order to build a more resilient network of care.
A workbook organizer, “Growing Your Resilience” has been created to accompany the #AETuesdayTries program and is located on the ‘Apps and Tools for AE Warriors’ page in the section: ‘Building Your Resilience’ on the IAES website under the ‘For Patients’ tab. A link to download the organizer is also provided within your e-mail confirmation when you register.
The next monthly #AETuesdayTries zoom meet-up will take place October 26th and will always be the last Tuesday of each month. Join AE patients and caregivers of all ages and stages in their AE journey. Receive insights and encouragement from others and celebrate your critical milestones in recovery and care while building a more resilient personal AE network!
Your facilitator, Tessa McKenzie, IAES’ Chief Resilience Officer, is a life coach and studies “resilience” through her private practice, Envisage Vocation Creation and work with Johns Hopkins University’s Life Design Lab. Join Tessa and other AE patients and caregivers who are ready to “Share Your Try Tuesdays”. Tessa will provide prompts for the reframe of perceived failures as well as peer-to-peer validation of “wins” and opportunities for relationship building.
Health At A Glance Form for AE Warriors
IAES has designed an Emergency AE Health form for AE Warriors that is specific to your needs. A one-page health record to list medical conditions, allergies, medications, immunizations, Doctor contact information that can be kept in your wallet.
You can find this form along with two other free tools, our AE Patient Emergency Medical Alert I.D. card, and our Autoimmune Encephalitis I.D. card which alerts to behavioral AE symptoms on the back of the card.
All three tools are located on the Apps and Tools for AE Warriors on the IAES website.
Use and Safety of Immunotherapeutic Management of N-Methyl-d-Aspartate Receptor Antibody Encephalitis: A Meta-analysis
If you have a diagnosis of anti-NMDAr encephalitis, this newly published key paper is one you should be aware of. A meta-analysis of 1,550 patients with NMDARE.
– Factors associated with good functional outcomes were adolescent age and first-line treatment with either plasmapheresis alone, corticosteroids with IVIG, or corticosteroids with IVIG and plasmapheresis.
– Factors associated with poor functional outcome were infant or older adult age, ICU admission, EEG extreme delta brush pattern, lack of immunotherapy ≤30 days of onset, and maintenance IVIG treatment for ≥six months.
– Relapsing disease was associated with adolescent age, and non-relapsing disease was associated with rituximab use or maintenance IVIG for ≥six months.
5 Halloween Worksheets
Get in the spirit of the season by having your child work with these Halloween themed worksheets. The goal of cognitive rehabilitation is to restore cognitive functions created by brain injury from Autoimmune Encephalitis. This process involves relearning cognitive skills that were lost. The ultimate goal for your AE Warrior is to restore the quality of life they had before their AE. The key is to incorporate fun activities and things they most enjoy doing into their rehabilitation.
These work sheets train vocabulary, the ability to analyze a visual scene and to identify important elements, working memory and recall, and visuospatial abilities and stimulating mental imagery.
ABI Rehabilitation From AE
Awareness Word Search
Helpful Tips for Patients & Families
Save on Property Taxes
For members in the U.S.A., many states offer a Homestead exemption to individuals who are disabled. This reduces the amount of taxes that are owed on the property. It usually requires your doctor to compete a form and documentation be provided. Each state is different, so each person should look up what their state provides.
Most Popular Download
Autoimmune Encephalitis Halloween
COVID-19’s Impact on the AE Community
Autoimmune Encephalitis Post-SARS-CoV-2 Infection: Case Frequency, Findings, and Outcomes
Results: Eighteen of the laboratory cohort (3%) were SARS-CoV-2 antibody positive (April-December 2020). Diagnoses were: AE, 2; post-acute sequelae of SARS CoV-2 infection [PASC], 3; toxic-metabolic encephalopathy during COVID-19 pneumonia, 2; diverse non-COVID-19 relatable neurological diagnoses, 9; unavailable, 2. Five of the encephalopathy cohort had AE (16%, including the 2 laboratory cohort cases which overlapped) representing 0.05% of 10,384 patients diagnosed and cared for with any COVID-19 illness at Mayo Clinic Rochester in 2020. The 5 patients met definite (n=1), probable (n=1), or possible (n=3) AE diagnostic criteria; median symptom onset age was 61 years (range, 46-63), 3 were women. All 5 were neural IgG negative and 4 tested were SARS-CoV-2 PCR/IgG index negative in CSF. Phenotypes (and accompanying MRI and EEG findings) were diverse (delirium [n=5], seizures [n=2], rhombencephalitis [n=1], aphasia [n=1], and ataxia [n=1]). No ADEM cases were encountered. The 3 patients with possible AE had spontaneously resolving syndromes. One with definite limbic encephalitis was immune therapy responsive but had residual mood and memory problems. One patient with probable autoimmune rhombencephalitis died despite immune therapy. The remaining 26 encephalopathy cohort patients had toxic-metabolic diagnoses.
Featured AE Article~
Long-term Cognitive Outcome in anti-NMDA receptor Encephalitis
This study presents comprehensive longitudinal data for the cognitive outcome in NMDAR encephalitis. All patients had cognitive deficits about 2 years after disease onset, mainly affecting memory and executive function. After 4 years, moderate or severe cognitive deficits persisted in 2/3 of patients despite good functional neurological outcome, indicating that cognitive function is an important outcome measure in addition to the functional neurological scales. Impaired cognitive outcome was predicted by delayed treatment and higher disease severity. However, continued improvement of cognitive function was observed for several years after disease onset in some patients.
These results demonstrate that cognitive deficits are frequent and severe long-term sequelae following NMDAR encephalitis. These deficits show a slow and incomplete recovery and persist beyond recovery of other neuropsychiatric symptoms of the disease. Consequently, our findings call for rapid diagnosis and treatment at disease onset as well as for continued and customized cognitive rehabilitation to improve the long-term outcome.
Successful Treatment with Immunoadsorption Therapy in Four Patients with Severe and Refractory anti-NMDAR Encephalitis
There is still no optimal treatment for patients with severe anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis refractory to first-line therapy (including intravenous methylprednisolone [IVMP] and intravenous immunoglobulin [IVIG]). A small study has shown that immunoadsorption (IA) is effective in treating anti-NMDAR encephalitis. However, the effectiveness and safety of IA in the treatment of patients with refractory and severe anti-NMDAR encephalitis is not fully known. Four patients with severe anti-NMDAR encephalitis are reported, which were refractory to the first-line immunotherapy including IVMP and IVIG. Immunoadsorption is performed during the fulminant stage of disease, and the effectiveness and safety of IA are assessed. The modified Rankin Scale (mRS) is used to assess neurological conditions before and after IA. Four patients with the most severe form of anti-NMDAR encephalitis (two with teratoma and two with unknown origin) did not respond to one or more rounds of IVMP plus IVIG. They all required intensive care unit (ICU) support including long-term mechanical ventilation, and thus developed ICU-related complications. Gradual and steady improvement was observed after IA treatment. Except for mild hypotension in patient 1, no other adverse events were observed during IA. Two patients had good early overall recovery on discharge. The other two patients had a good outcome with mRS of 2 at the 12-month follow-up. This small case series suggests that IA may be an effective treatment option to accelerate the recovery of patients with severe and refractory anti-NMDAR encephalitis.
COVID-19 Clinician’s Corner
Frequency of Neurologic Manifestations in COVID-19:
A Systematic Review and Meta-analysis
350 studies were included in this review, providing data on 145,721 COVID-19 patients, 89% of whom were hospitalized. Forty-one neurological manifestations (24 symptoms and 17 diagnoses) were identified. Pooled prevalence of the most common neurological symptoms included: fatigue (32%), myalgia (20%), taste impairment (21%), smell impairment (19%) and headache (13%). A low risk of bias was observed in 85% of studies; studies with higher risk of bias yielded higher prevalence estimates. Stroke was the most common neurological diagnosis (pooled prevalence- 2%). In COVID-19 patients aged ≥60, the pooled prevalence of acute confusion/delirium was 34% and the presence of any neurological manifestations in this age group was associated with mortality (95%).
A Validated Nomogram That Predicts Prognosis of Autoimmune Encephalitis: A Multicenter Study in China
The primary goals of the study were: (1) to develop early predictive model which distinguished poor from good prognosis of patients with AE using a nomogram; and (2) to evaluate nomogram performance using patient-level independent data. 173 subjects were included in the final analysis.
In this study, we identified age, viral prodrome, consciousness impairment, memory dysfunction and autonomic dysfunction for predicting poor prognosis of AE at discharge using a multivariable regression model. We found that elderly patients were more likely to have poor prognosis than younger individuals. The nomogram, deriving from the model, could accurately predict prognosis in patients with AE graphically and provided a personalized outlook. Our study creates a novel model to pick up patients who probably receive poor prognosis and allows physicians to provide a tailored clinical therapeutic regimen for each patient. Precision medicine for AE patients would lead to favorable prognosis and save their medical cost.
AE Trivia Playing Cards
The perfect companion for patients, caregivers & therapists
We appreciate the National Organization of Rare Diseases’ (NORD) enthusiastic support in recommending this groundbreaking product.
AE Warrior Store
New Arrivals ~ The AE Wingman Collection
|New arrivals at The AE Warrior Store. We are pleased to present ~The AE Wingman Collection. Get some swag for your spouse, partner, BFF, caregiver, or advocate that is sure to bring a smile and remind them of how proud you are of their fighting spirit and dedication to helping you on your AE journey.|
Any AE Warrior knows that we are NOTHING without our #AEWingman’s support and guidance. Our Wingman is the person who has been right by our side encouraging us every inch of our AE journey.
The moniker “AE Wingman” should invoke a sense of pride and reaffirmation of the courage and determination it has taken to advocate so long and hard to help us regain health.
Don’t forget to #GiveAtCheckOut if you purchase your gift through PayPal! (See: Shop and Support IAES Through PayPal’s #GiveAtCheckOut program below).
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 that may one day lead to a cure.
Shop & Support IAES Through PayPal’s
|Get that great deal online and support IAES at the same time!|
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.
This simple act of kindness, will support the work we do and advance our ability to service the community.
Smilematic, is a handy tool that will automatically redirect you to smile.amazon.com when you are shopping so you never have to worry about forgetting to type it in to ensure benefits go to IAES.
Donations raised are greatly appreciated and directly support research, patients, caregivers, and families through their journey so the best outcomes can 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.