Symptom characteristics of autoimmune encephalitis and the causes of misdiagnoses as mental-related problems
Objective:To discuss and summarize the symptoms and characteristics of autoimmune en-cephalitis,and to analyze the reasons of misdiagnoses.Method:A retrospective study was conducted on 15 patients with autoimmune encephalitis admitted to the 904th Hospital of the Joint Logistics Support Force from June 2015 to June 2021,and the literature was analyzed.Results:Among the 15 patients,9 were male and 6 were female.10 cases were anti-N-methyl-D-aspartate receptor(NMDAR)encephalitis,2 cases were anti-γ-aminobutyric acid type B receptor(GABABR)antibody-related encephalitis,and 2 cases were anti-LGI1 One case was anti-metabotropic glutamate receptor 5(mGluR5)encephalitis.Among the 15 patients,7 had prodro-mal infection-like symptoms,5 had mental stimuli before onset,13 had abnormal mental behavior,7 had tonic-clonic seizures,6 had involuntary movements,and 12 had cognitive impairment.There were 6 cases of disturb-ance of consciousness and 9 cases of autonomic dysfunction.Of the 15 patients,6 were seriously ill.The main reasons for the severe illness were disturbance of consciousness,central hypoventilation,and pulmonary infec-tion.Among the 15 patients with brain magnetic resonance imaging(MRI),10 had new abnormal lesions,7 had abnormal cerebrospinal fluid pressure,6 had abnormal protein,and 4 had abnormal cell count.Electroencephalo-graphy was not done in 3 cases.In the remaining 12 cases,4 cases were normal,8 cases showed slow waves,and 6 cases had sharp waves at the same time.Conclusion:Autoimmune encephalitis is often accompanied by psychiatric symptoms,and atypical psychiatric symptoms,some with early stress psychological factors inparticu-lar,which are the reasons why it is easily misdiagnosed as functional mental disorders.In the course of treat-ment,the manifestations of autonomic dysfunction are easily considered as drug-induced.
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