Management strategy for recurrent encephalitis and meningitis

doi:10.3969/j.issn.1672-6731.2022.01.006

Abstract

Abstract: Encephalitis/meningitis includes infectious and non-infectious. With the improvement of diagnostic technology and the summary of clinical experience, its diagnosis and treatment are becoming more and more clear. However, for relapsed patients, how to control risk factors and prevent disease progression and relapse remains inconclusive. This article summarizes the recurrence factors of different types of encephalitis/meningitis and the treatment plan after recurrence, in order to improve clinicians' attention and management of recurrent encephalitis/meningitis, and improve the prognosis of patients.

Key words: Encephalitis, Meningitis, Autoimmune diseases, Recurrence, Review

摘要： 脑炎/脑膜炎包括感染性和非感染性，随着诊断技术的提高和临床经验的总结，其诊断与治疗越来越明确。然而对于复发患者，如何控制危险因素、预防疾病进展和复发尚无定论。本文对不同类型脑炎/脑膜炎的复发因素及复发后治疗方案进行总结，以提高临床医师对复发性脑炎/脑膜炎的重视与管理，改善患者预后。

关键词: 脑炎, 脑膜炎, 自身免疫疾病, 复发, 综述

ZHAO Li, WANG Jia-wei. Management strategy for recurrent encephalitis and meningitis[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2022, 22(1): 38-45.

赵丽, 王佳伟. 复发性脑炎/脑膜炎管理策略[J]. 中国现代神经疾病杂志, 2022, 22(1): 38-45.

/ / Recommend / Download Citations

URL: https://journal11.magtechjournal.com/cjcnn/EN/10.3969/j.issn.1672-6731.2022.01.006

https://journal11.magtechjournal.com/cjcnn/EN/Y2022/V22/I1/38

References

[1] Smith JE, Aksamit AJ Jr. Outcome of chronic idiopathic meningitis [J]. Mayo Clin Proc, 1994, 69: 548-556.
[2] Rosenberg J, Galen BT. Recurrent meningitis[J]. Curr Pain Headache Rep, 2017, 21: 33.
[3] Aksamit AJ. Chronic meningitis[J]. N Engl J Med, 2021, 385: 930-936.
[4] Dalmau J, Tüzün E, Wu HY, Masjuan J, Rossi JE, Voloschin A, Baehring JM, Shimazaki H, Koide R, King D, Mason W, Sansing LH, Dichter MA, Rosenfeld MR, Lynch DR. Paraneoplastic anti - N - methyl - D - aspartate receptor encephalitis associated with ovarian teratoma[J]. Ann Neurol, 2007, 61: 25-36.
[5] Tebruegge M, Curtis N. Epidemiology, etiology, pathogenesis, and diagnosis of recurrent bacterial meningitis [J]. Clin Microbiol Rev, 2008, 21: 519-537.
[6] van de Beek D, Brouwer MC, Koedel U, Wall EC. Community- acquired bacterial meningitis[J]. Lancet, 2021, 398: 1171-1183.
[7] Wall EC, Chan JM, Gil E, Heyderman RS. Acute bacterial meningitis [J]. Curr Opin Neurol, 2021, 34: 386-395.
[8] Ter Horst L, Brouwer MC, van der Ende A, van de Beek D. Recurrent community - acquired bacterial meningitis in adults [J]. Clin Infect Dis, 2021, 73: e2545-2551.
[9] Ter Horst L, Brouwer MC, van der Ende A, van de Beek D. Community - acquired bacterial meningitis in adults with cerebrospinal fluid leakage[J]. Clin Infect Dis, 2020, 70: 2256-2261.
[10] Brouwer MC, de Gans J, Heckenberg SG, Zwinderman AH, van der Poll T, van de Beek D. Host genetic susceptibility to pneumococcal and meningococcal disease: a systematic review and meta-analysis [J]. Lancet Infect Dis, 2009, 9: 31-44.
[11] Ratilal BO, Costa J, Pappamikail L, Sampaio C. Antibiotic prophylaxis for preventing meningitis in patients with basilar skull fractures[J]. Cochrane Database Syst Rev, 2015, (4): CD004884.
[12] Norris PAA, Kaur G, Lazarus AH. New insights into IVIg mechanisms and alternatives in autoimmune and inflammatory diseases [J]. Curr Opin Hematol, 2020, 27: 392-398.
[13] Grandgirard D, Schürch C, Cottagnoud P, Leib SL. Prevention of brain injury by the nonbacteriolytic antibiotic daptomycin in experimental pneumococcal meningitis[J]. Antimicrob Agents Chemother, 2007, 51: 2173-2178.
[14] Kasanmoentalib ES, Valls Seron M, Morgan BP, Brouwer MC, van de Beek D. Adjuvant treatment with dexamethasone plus anti - C5 antibodies improves outcome of experimental pneumococcal meningitis: a randomized controlled trial[J]. J Neuroinflammation, 2015, 12: 149.
[15] Liu ZY, Wang GQ, Zhu LP, Lü XJ, Zhang QQ, Yu YS, Zhou ZH, Liu YB, Cai WP, Li RY, Zhang WH, Zhang FJ, Wu H, Xu YC, Lu HZ, Li TS. Expert consensus on the diagnosis and treatment of cryptococcal meningitis[J]. Zhonghua Nei Ke Za Zhi, 2018, 57: 317-323. 刘正印, 王贵强, 朱利平, 吕晓菊, 章强强, 俞云松, 周志慧, 刘焱斌, 蔡卫平, 李若瑜, 张文宏, 张福杰, 吴昊, 徐英春, 卢洪洲, 李太生. 隐球菌性脑膜炎诊治专家共识[J]. 中华内科杂志, 2018, 57: 317-323.
[16] Jarvis JN, Meintjes G, Williams Z, Rebe K, Harrison TS. Symptomatic relapse of HIV - associated cryptococcal meningitis in South Africa: the role of inadequate secondary prophylaxis [J]. S Afr Med J, 2010, 100: 378-382.
[17] Musubire AK, Boulware DR, Meya DB, Rhein J. Diagnosis and management of cryptococcal relapse[J]. J AIDS Clin Res, 2013, Suppl 3: 3-003.
[18] Liao CH, Chi CY, Wang YJ, Tseng SW, Chou CH, Ho CM, Lin PC, Ho MW, Wang JH. Different presentations and outcomes between HIV - infected and HIV - uninfected patients with cryptococcal meningitis[J]. J Microbiol Immunol Infect, 2012, 45: 296-304.
[19] Jarvis JN, Dromer F, Harrison TS, Lortholary O. Managing cryptococcosis in the immunocompromised host[J]. Curr Opin Infect Dis, 2008, 21: 596-603.
[20] Boulware DR, Meya DB, Muzoora C, Rolfes MA, Huppler Hullsiek K, Musubire A, Taseera K, Nabeta HW, Schutz C, Williams DA, Rajasingham R, Rhein J, Thienemann F, Lo MW, Nielsen K, Bergemann TL, Kambugu A, Manabe YC, Janoff EN, Bohjanen PR, Meintjes G; COAT Trial Team. Timing of antiretroviral therapy after diagnosis of cryptococcal meningitis[J]. N Engl J Med, 2014, 370: 2487-2498.
[21] Ge Y, Fan SY, Chen JH, Shen A, Dou HT, Xiao M, Xu YC, Gong YP, Ren HT, Wu HL, Guan HZ. Analysis of metagenomic next - generation sequencing of cerebrospinal fluid from patients with cryptococcal meningitis[J]. Xie He Yi Xue Za Zhi, 2019, 10: 605-611. 葛瑛, 范思远, 陈健华, 申奥, 窦洪涛, 肖盟, 徐英春, 宫燕萍, 任海涛, 吴红龙, 关鸿志. 隐球菌脑膜炎患者脑脊液宏基因组二代测序结果分析[J]. 协和医学杂志, 2019, 10: 605-611.
[22] Henao-Martínez AF, Chastain DB, Franco-Paredes C. Treatment of cryptococcosis in non -HIV immunocompromised patients[J]. Curr Opin Infect Dis, 2018, 31: 278-285.
[23] Li Y, Lu Y, Nie J, Liu M, Yuan J, Li Y, Li H, Chen Y. Potential predictors and survival analysis of the relapse of HIV- associated cryptococcal meningitis: a retrospective study[J]. Front Med (Lausanne), 2021, 8: 626266.
[24] Srichatrapimuk S, Sungkanuparph S. Integrated therapy for HIV and cryptococcosis [J]. AIDS Res Ther, 2016, 13: 42.
[25] Shalabi M, Whitley RJ. Recurrent benign lymphocytic meningitis [J]. Clin Infect Dis, 2006, 43: 1194-1197.
[26] Rathi N, Rathi A. Relapse of herpes simplex encephalitis presenting as choreoathetosis[J]. Indian J Pediatr, 2010, 77: 901-902.
[27] Spiegel R, Miron D, Yodko H, Lumelsky D, Habib A, Horovitz Y. Late relapse of herpes simplex virus encephalitis in a child due to reactivation of latent virus: clinicopathological report and review[J]. J Child Neurol, 2008, 23: 344-348.
[28] Alsweed A, Alsuhibani M, Casanova JL, Al-Hajjar S. Approach to recurrent herpes simplex encephalitis in children[J]. Int J Pediatr Adolesc Med, 2018, 5: 35-38.
[29] Barthez - Carpentier MA, Rozenberg F, Dussaix E, Lebon P, Goudeau A, Billard C, Tardieu M. Relapse of herpes simplex encephalitis [J]. J Child Neurol, 1995, 10: 363-368.
[30] Armangue T, Moris G, Cantarín - Extremera V, Conde CE, Rostasy K, Erro ME, Portilla - Cuenca JC, Turón - Viñas E, Málaga I, Muñoz - Cabello B, Torres - Torres C, Llufriu S, González-Gutiérrez-Solana L, González G, Casado-Naranjo I, Rosenfeld M, Graus F, Dalmau J; Spanish Prospective Multicentric Study of Autoimmunity in Herpes Simplex Encephalitis. Autoimmune post - herpes simplex encephalitis of adults and teenagers [J]. Neurology, 2015, 85: 1736-1743.
[31] Hacohen Y, Deiva K, Pettingill P, Waters P, Siddiqui A, Chretien P, Menson E, Lin JP, Tardieu M, Vincent A, Lim MJ. N-methyl-D-aspartate receptor antibodies in post-herpes simplex virus encephalitis neurological relapse[J]. Mov Disord, 2014, 29: 90-96.
[32] Armangue T, Leypoldt F, Málaga I, Raspall-Chaure M, Marti I, Nichter C, Pugh J, Vicente - Rasoamalala M, Lafuente - Hidalgo M, Macaya A, Ke M, Titulaer MJ, Höftberger R, Sheriff H, Glaser C, Dalmau J. Herpes simplex virus encephalitis is a trigger of brain autoimmunity[J]. Ann Neurol, 2014, 75: 317-323.
[33] Schleede L, Bueter W, Baumgartner - Sigl S, Opladen T, Weigt-Usinger K, Stephan S, Smitka M, Leiz S, Kaiser O, Kraus V, van Baalen A, Skopnik H, Hartmann H, Rostasy K, Lücke T, Schara U, Häusler M. Pediatric herpes simplex virus encephalitis: a retrospective multicenter experience[J]. J Child Neurol, 2013, 28: 321-331.
[34] Sköldenberg B, Aurelius E, Hjalmarsson A, Sabri F, Forsgren M, Andersson B, Linde A, Strannegård O, Studahl M, Hagberg L, Rosengren L. Incidence and pathogenesis of clinical relapse after herpes simplex encephalitis in adults[J]. J Neurol, 2006, 253: 163-170.
[35] Alonso-Vanegas MA, Quintero-López E, Martínez-Albarrán AA, Moreira - Holguín JC. Recurrent herpes simplex virus encephalitis after neurologic surgery[J]. World Neurosurg, 2016, 89: 731.
[36] Chi BW, Wang JW. Progression in autoimmune encephalitis after herpes simplex virus infection[J]. Shou Du Yi Ke Da Xue Xue Bao, 2021, 42: 341-346. 迟博闻, 王佳伟. 单纯疱疹病毒感染后自身免疫性脑炎的研究进展[J]. 首都医科大学学报, 2021, 42: 341-346.
[37] Qiao S, Wu HK, Liu LL, Zhang RR, Wang ML, Han T, Zhang SC, Liu XW. Characteristics and prognosis of autoimmune encephalitis in the east of China: a multi-center study[J]. Front Neurol, 2021, 12: 642078.
[38] Franzen-Röhl E, Schepis D, Atterfelt F, Franck K, Wikström A, Liljeqvist JÅ, Bergström T, Aurelius E, Kärre K, Berg L, Gaines H. Herpes simplex virus specific T cell response in a cohort with primary genital infection correlates inversely with frequency of subsequent recurrences[J]. Sex Transm Infect, 2017, 93: 169-174.
[39] Bruyn GW, Straathof LJ, Raymakers GM. Mollaret's meningitis: differential diagnosis and diagnostic pitfalls[J]. Neurology, 1962, 12: 745-753.
[40] Aurelius E, Franzen - Röhl E, Glimåker M, Akre O, Grillner L, Jorup-Rönström C, Studahl M; HSV -2 Meningitis Study Group. Long - term valacyclovir suppressive treatment after herpes simplex virus type 2 meningitis: a double - blind, randomized controlled trial [J]. Clin Infect Dis, 2012, 54: 1304-1313.
[41] Zammarchi L, Montagnani F, Tordini G, Gotuzzo E, Bisoffi Z, Bartoloni A, De Luca A. Persistent strongyloidiasis complicated by recurrent meningitis in an HTLV seropositive Peruvian migrant resettled in Italy[J]. Am J Trop Med Hyg, 2015, 92: 1257-1260.
[42] Zhang ML, Ma WF, Gao XY, Shi YY, Liu HQ, Jiang YS, Qin LZ, Yuan LP, Li W, Zhang JW. Clinical features and prognosis of patients with leptomeningeal metastases[J]. Zhonghua Yi Xue Za Zhi, 2021, 101: 1154-1159. 张弥兰, 马伟锋, 高鑫雅, 时英英, 刘慧勤, 蒋玙姝, 秦灵芝, 袁丽品, 李玮, 张杰文. 脑膜癌病患者临床特征及预后分析[J]. 中华医学杂志, 2021, 101: 1154-1159.
[43] Sahin Eroglu D, Torgutalp M, Yucesan C, Sezer S, Yayla ME, Boyvat A, Ates A. Prognostic factors for relapse and poor outcome in neuro - Behçet's syndrome: results from a clinical long - term follow - up of a single centre[J]. J Neurol, 2021. [Epub ahead of print]
[44] Zeydan B, Uygunoglu U, Saip S, Demirci ON, Seyahi E, Ugurlu S, Hamuryudan V, Siva A, Kantarci OH. Infliximab is a plausible alternative for neurologic complications of Behçet disease [J]. Neurol Neuroimmunol Neuroinflamm, 2016, 3: e258.
[45] Bi Z, Shang K, Cao J, Su Z, Bu B, Xu S, Liu C. Hypertrophic pachymeningitis in Chinese patients: presentation, radiological findings, and clinical course[J]. Biomed Res Int, 2020: 2926419.
[46] Peng Y, Dai F, Liu L, Chen W, Yan H, Liu A, Zhang X, Wang X, He J, Li Y, Li C, Chen L, Zhao Y, Li L, Ma Q, Wang J. Validation of the NEOS score in Chinese patients with anti - NMDAR encephalitis[J]. Neurol Neuroimmunol Neuroinflamm, 2020, 7: e860.
[47] Xu X, Lu Q, Huang Y, Fan S, Zhou L, Yuan J, Yang X, Ren H, Sun D, Dai Y, Zhu H, Jiang Y, Zhu Y, Peng B, Cui L, Guan H. Anti-NMDAR encephalitis: a single-center, longitudinal study in China [J]. Neurol Neuroimmunol Neuroinflamm, 2019, 7: e633.
[48] Titulaer MJ, McCracken L, Gabilondo I, Armangué T, Glaser C, Iizuka T, Honig LS, Benseler SM, Kawachi I, Martinez - Hernandez E, Aguilar E, Gresa - Arribas N, Ryan - Florance N, Torrents A, Saiz A, Rosenfeld MR, Balice - Gordon R, Graus F, Dalmau J. Treatment and prognostic factors for long - term outcome in patients with anti - NMDA receptor encephalitis: an observational cohort study[J]. Lancet Neurol, 2013, 12: 157-165.
[49] Zeng W, Cao L, Zheng J, Yu L. Clinical characteristics and long- term prognosis of relapsing anti-N -methyl-D -aspartate receptor encephalitis: a retrospective, multicenter, self-controlled study[J]. Neurol Sci, 2021, 42: 199-207.
[50] Wang GL, Yin F, Wang Y, Zhang WX, He F, Yang LF, Wu LW, Peng J. Clinical analysis of 71 cases of anti-N -methyl-D - aspartate receptor encephalitis in children[J]. Zhonghua Er Ke Za Zhi, 2019, 57: 125-130.
[51] Raja P, Shamick B, Nitish LK, Holla VV, Pal PK, Mahadevan A, Thomas PT, Maya B, Saini J, Shantala H, Netravathi M. Clinical characteristics, treatment and long - term prognosis in patients with anti - NMDAR encephalitis[J]. Neurol Sci, 2021, 42: 4683-4696.
[52] Li X, Hou C, Wu WL, Liang H, Zheng K, Zhang Y, Zeng Y, Chen L, Zhu H, Tian Y, Gao Y, Peng B, Yang S, Wang X, Ning S, Liao Y, Lin H, Chen WX. Pediatric anti - N - methyl - D - aspartate receptor encephalitis in southern China: analysis of 111 cases [J]. J Neuroimmunol, 2021, 352: 577479.
[53] Guang S, Ma J, Ren X, Zhou S, Yang J, Zhang J, Cao X, Zhong L, Ding X, Wang X, Ren C, Zhang W, Zhang L, Zhang M, Sun J, Kessi M, Yin F, Peng J, Jiang Y. Immunotherapies for anti-N-methyl - D - aspartate receptor encephalitis: multicenter retrospective pediatric cohort study in China[J]. Front Pediatr, 2021, 9: 691599.
[54] Hirose S, Hara M, Kamei S, Dalmau J, Nakajima H. Characteristics of clinical relapses and patient - oriented long - term outcomes of patients with anti - N - methyl - D - aspartate receptor encephalitis[J]. J Neurol, 2021. [Epub ahead of print]
[55] Nissen MS, Ørvik MS, Nilsson AC, Ryding M, Lydolph M, Blaabjerg M. NMDA - receptor encephalitis in Denmark from 2009 to 2019: a national cohort study[J]. J Neurol, 2021. [Epub ahead of print]
[56] Wang Y, Miao A, Shi Y, Ge J, Wang L, Yu C, Xu H, Yu Y, Huang S, Li Y, Wang X. Influencing electroclinical features and prognostic factors in patients with anti - NMDAR encephalitis: a cohort follow - up study in Chinese patients[J]. Sci Rep, 2020, 10: 10753.
[57] Zhang L, Lu Y, Xu L, Liu L, Wu X, Zhang Y, Zhu G, Hong Z. Anti - N - methyl - D - aspartate receptor encephalitis with accompanying ovarian teratoma in female patients from East China: clinical features, treatment, and prognostic outcomes[J]. Seizure, 2020, 75: 55-62.
[58] Nosadini M, Granata T, Matricardi S, Freri E, Ragona F, Papetti L, Suppiej A, Valeriani M, Sartori S; Italian Working Group on Paediatric Anti - N - methyl - D - aspartate Receptor Encephalitis. Relapse risk factors in anti-N -methyl-D -aspartate receptor encephalitis[J]. Dev Med Child Neurol, 2019, 61: 1101-1107.
[59] Spatola M, Petit Pedrol M, Maudes E, Simabukuro M, Muñiz - Castrillo S, Pinto AL, Wandinger KP, Spiegler J, Schramm P, Dutra LA, Iorio R, Kornblum C, Bien CG, Höftberger R, Leypoldt F, Titulaer MJ, Sillevis Smitt P, Honnorat J, Rosenfeld MR, Graus F, Dalmau J. Clinical features, prognostic factors, and antibody effects in anti - mGluR1 encephalitis [J]. Neurology, 2020, 95: e3012-3025.
[60] Li W, Wu S, Meng Q, Zhang X, Guo Y, Cong L, Cong S, Zheng D. Clinical characteristics and short - term prognosis of LGI1 antibody encephalitis: a retrospective case study[J]. BMC Neurol, 2018, 18: 96.
[61] Li TR, Zhang YD, Wang Q, Shao XQ, Lyu DY, Lv RJ. Clinical characteristics and long - term prognosis of anti - LGI1 encephalitis: a single - center cohort study in Beijing, China[J]. Front Neurol, 2021, 12: 674368.
[62] Ghimire P, Khanal UP, Gajurel BP, Karn R, Rajbhandari R, Paudel S, Gautam N, Ojha R. Anti - LGI1, anti - GABABR, and anti - CASPR2 encephalitides in Asia: a systematic review[J]. Brain Behav, 2020, 10: e01793.
[63] Yang X, Li AN, Zhao XH, Liu XW, Wang SJ. Clinical features of patients with anti - leucine - rich glioma inactivated - 1 protein associated encephalitis: a Chinese case series [J]. Int J Neurosci, 2019, 129: 754-761.
[64] Qiao S, Wu HK, Liu LL, Wang ML, Zhang RR, Han T, Liu XW. Clinical features and long - term outcomes of anti - leucine - rich glioma-inactivated 1 encephalitis: a multi-center study[J]. Neuropsychiatr Dis Treat, 2021, 17: 203-212.
[65] Zhang X, Lang Y, Sun L, Zhang W, Lin W, Cui L. Clinical characteristics and prognostic analysis of anti - gamma - aminobutyric acid - B (GABA - B) receptor encephalitis in Northeast China[J]. BMC Neurol, 2020, 20: 1.
[66] Lin J, Li C, Li A, Liu X, Wang R, Chen C, Zhou D, Hong Z. Encephalitis with antibodies against the GABAB receptor: high mortality and risk factors[J]. Front Neurol, 2019, 10: 1030.
[67] Höftberger R, van Sonderen A, Leypoldt F, Houghton D, Geschwind M, Gelfand J, Paredes M, Sabater L, Saiz A, Titulaer MJ, Graus F, Dalmau J. Encephalitis and AMPA receptor antibodies: novel findings in a case series of 22 patients [J]. Neurology, 2015, 84: 2403-2412.
[68] Gabilondo I, Saiz A, Galán L, González V, Jadraque R, Sabater L, Sans A, Sempere A, Vela A, Villalobos F, Viñals M, Villoslada P, Graus F. Analysis of relapses in anti - NMDAR encephalitis [J]. Neurology, 2011, 77: 996-999.
[69] Nosadini M, Eyre M, Molteni E, Thomas T, Irani SR, Dalmau J, Dale RC, Lim M, Anlar B, Armangue T, Benseler S, Cellucci T, Deiva K, Gallentine W, Gombolay G, Gorman MP, Hacohen Y, Jiang Y, Lim BC, Muscal E, Ndondo A, Neuteboom R, Rostásy K, Sakuma H, Sartori S, Sharma S, Tenembaum SN, Van Mater HA, Wells E, Wickstrom R, Yeshokumar AK; International NMDAR Antibody Encephalitis Consensus Group. Use and safety of immunotherapeutic management of N - Methyl - D - aspartate receptor antibody encephalitis: a meta - analysis[J]. JAMA Neurol, 2021, 78: 1333-1344.
[70] Maureille A, Fenouil T, Joubert B, Picard G, Rogemond V, Pinto AL, Thomas L, Ducray F, Quadrio I, Psimaras D, Berzero G, Antoine JC, Desestret V, Honnorat J. Isolated seizures are a common early feature of paraneoplastic anti - GABAB receptor encephalitis [J]. J Neurol, 2019, 266: 195-206.
[71] Gresa - Arribas N, Titulaer MJ, Torrents A, Aguilar E, McCracken L, Leypoldt F, Gleichman AJ, Balice - Gordon R, Rosenfeld MR, Lynch D, Graus F, Dalmau J. Antibody titres at diagnosis and during follow - up of anti - NMDA receptor encephalitis: a retrospective study[J]. Lancet Neurol, 2014, 13: 167-177.
[72] Lai M, Huijbers MG, Lancaster E, Graus F, Bataller L, Balice-Gordon R, Cowell JK, Dalmau J. Investigation of LGI1 as the antigen in limbic encephalitis previously attributed to potassium channels: a case series [J]. Lancet Neurol, 2010, 9: 776-785.
[73] Ramberger M, Berretta A, Tan JMM, Sun B, Michael S, Yeo T, Theorell J, Bashford - Rogers R, Paneva S, O'Dowd V, Dedi N, Topia S, Griffin R, Ramirez-Franco J, El Far O, Baulac S, Leite MI, Sen A, Jeans A, McMillan D, Marshall D, Anthony D, Lightwood D, Waters P, Irani SR. Distinctive binding properties of human monoclonal LGI1 autoantibodies determine pathogenic mechanisms [J]. Brain, 2020, 143: 1731-1745.
[74] Abboud H, Probasco J, Irani SR, Ances B, Benavides DR, Bradshaw M, Christo PP, Dale RC, Fernandez - Fournier M, Flanagan EP, Gadoth A, George P, Grebenciucova E, Jammoul A, Lee ST, Li Y, Matiello M, Morse AM, Rae-Grant A, Rojas G, Rossman I, Schmitt S, Venkatesan A, Vernino S, Pittock SJ, Titulaer M; Autoimmune Encephalitis Alliance Clinicians Network. Autoimmune encephalitis: proposed recommendations for symptomatic and long - term management[J]. J Neurol Neurosurg Psychiatry, 2021, 92: 897-907.
[75] Dalmau J, Lancaster E, Martinez - Hernandez E, Rosenfeld MR, Balice - Gordon R. Clinical experience and laboratory investigations in patients with anti - NMDAR encephalitis[J]. Lancet Neurol, 2011, 10: 63-74.

Please choose a citation manager

Content to export