Autoimmune Encephalitis: Insights Into Immune-Mediated Central Nervous System Injury.

IF 4.4 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Vivek Pai, Heejun Kang, Suradech Suthiphosuwan, Andrew Gao, Daniel Mandell, Manohar Shroff
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引用次数: 0

Abstract

Autoimmune encephalitis (AE) is a category of immune-mediated disorders of the central nervous system (CNS) affecting children and adults. It is characterized by the subacute onset of altered mentation, neurocognitive issues, refractory seizures/drug-resistant epilepsy, movement disorders, and/or autonomic dysfunction. AE is mediated by autoantibodies targeting specific surface components or intracytoplasmic antigens in the CNS, leading to functional or structural alterations. Multiple triggers that induce autoimmunity have been described, which are mainly parainfectious and paraneoplastic. The imaging features of AE often overlap with each other and with other common causes of encephalitis/encephalopathy (infections and toxic-metabolic etiologies). Limbic encephalitis is the most common imaging finding shared by most of these entities. Cortical, basal ganglia, diencephalon, and brainstem involvement may also be present. Cerebellar involvement is rare and is often a part of paraneoplastic degeneration. Owing to an improved understanding of AE, their incidence and detection have increased. Hence, in an appropriate setting, a high degree of suspicion is crucial when reporting clinical MRIs to ensure prompt treatment and better patient outcomes. In this review, we discuss the pathophysiology of AE and common etiologies encountered in clinical practice.

自身免疫性脑炎:洞察免疫介导的中枢神经系统损伤
自身免疫性脑炎(AE)是一类由免疫介导的中枢神经系统(CNS)疾病,多发于儿童和成人。其特点是亚急性发病,表现为精神改变、神经认知问题、难治性癫痫发作/耐药性癫痫、运动障碍和/或自主神经功能障碍。自身免疫性疾病是由针对中枢神经系统特定表面成分或细胞质内抗原的自身抗体介导的,从而导致功能或结构改变。目前已描述了多种诱发自身免疫的因素,主要是副感染性和副肿瘤性因素。边缘性脑炎的影像学特征往往与其他常见的脑炎/脑病病因(感染和中毒性代谢病因)相互重叠。边缘性脑炎是大多数此类疾病最常见的影像学表现。皮质、基底节、间脑和脑干也可能受累。小脑受累很少见,通常是副肿瘤变性的一部分。由于对 AE 的认识有所提高,其发病率和检出率也有所上升。因此,在适当的情况下,报告临床磁共振成像时必须高度怀疑,以确保及时治疗和更好的患者预后。在这篇综述中,我们将讨论 AE 的病理生理学和临床实践中常见的病因。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Korean Journal of Radiology
Korean Journal of Radiology 医学-核医学
CiteScore
10.60
自引率
12.50%
发文量
141
审稿时长
1.3 months
期刊介绍: The inaugural issue of the Korean J Radiol came out in March 2000. Our journal aims to produce and propagate knowledge on radiologic imaging and related sciences. A unique feature of the articles published in the Journal will be their reflection of global trends in radiology combined with an East-Asian perspective. Geographic differences in disease prevalence will be reflected in the contents of papers, and this will serve to enrich our body of knowledge. World''s outstanding radiologists from many countries are serving as editorial board of our journal.
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