Two physicians from the Mayo Clinic have just published a paper for clinicians discussing the diagnostic testing available for the many autoimmune neurological illnesses including AE and its various forms. They also included treatment approaches used by their institution and many others. A few highlights include:
- These disorders often develop rather quickly and produce many diverse symptoms, both in the central and peripheral nervous system.
- This group of diseases is likely more common than previously thought.
- New antibody biomarkers are being discovered, but not all patients have an antibody.
- Early diagnosis and treatment improves outcomes.
- These disorders can be associated with cancer, so screening is often part of the workup, depending on the patient’s symptoms and history.
- Current treatment methods are based on expert opinion as no prospective clinical trials have been completed yet.
- Steroids, IVIG and/or plasma exchange are widely used first line therapies; rituximab and cyclophosphamide are second line. Other treatments are being investigated and show promise for those not responding well to first and second-line.
- Response time to treatment can vary, depending on the antibody. With anti-NMDA receptor AE, it can take weeks to months for a response while anti-LGI1 AE may show a response within days.
- Some patients require maintenance therapy to prevent relapses.
This study was authored by Dr. A. Sebastian Lopez-Chiriboga and Dr. Eoin P. Flanagan of the Mayo Clinic. We are thankful for the hard work being done by these and many other physicians to research, report and utilize new discoveries in AE to benefit the lives of patients touched by this potentially devastating disease.