A comprehensive approach to treatment is important for patients with autoimmune neurological diseases. In a review article published in Neurology, the study authors discussed the importance of long-term, comprehensive care for this population group.
Autoimmune neurology is a rapidly evolving subspecialty in modern neurology, fueled by the continued discoveries of autoantibodies and the increasing recognition of autoimmunity as the basis of neurological disease. This review focused on autoimmune encephalitis in adulthood, but also applies to other autoimmune neurological diseases, including those affecting the peripheral and autonomic nervous systems.
The initial diagnosis of autoimmune encephalitis can be delayed as patients with various symptoms can present themselves in disciplines other than neurology. While consensus criteria for autoimmune encephalitis can help diagnose, subtle or atypical presentations can be more challenging.
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In most cases, autoimmune encephalitis requires specialized care with advanced diagnostic imaging and treatment from providers experienced in the treatment of autoimmune encephalitis. Although the disease can be severe, in most cases a significant recovery is expected.
The 9-item clinical rating scale for autoimmune encephalitis can help overcome some of the limitations of the initial assessment of autoimmune encephalitis. In addition, the NMDAR Encephalitis One Year Functional Status Score was created to predict the functional status of patients.
There are several benefits to targeted interventions at the time of discharge, including relieving the burden on family members, reducing hospital admissions, and improving patient outcomes. Follow-up appointments should be arranged for close monitoring, which can be extended depending on the clinical condition of the patient.
A multidisciplinary clinical team is valuable and can provide guidance and develop a care plan with data showing improved patient care and quality of life with coordinated clinics.
Multidisciplinary autoimmune neurological care should be led by a neurologist with expertise in autoimmune neurological diseases and, if necessary, also include experts from other areas such as psychiatry, neuropsychology, rehabilitation services, other neurological sub-areas and additional medical sub-areas. General practitioners play an essential role in the care and treatment of these patients. It is also important to incorporate research into multidisciplinary care.
“The ultimate goal is to provide optimal, long-term outpatient care that is coordinated between clinicians while anticipating the needs of patients and caregivers,” the review authors concluded.
Disclosure: Some study authors stated links with biotech, pharmaceutical, and / or device companies. For a full list of the author’s disclosures, see the original reference.
reference
Abbatemarco JR, Rodenbeck SJ, Day GS, Titulaer MJ, Yeshokumar AK, Clardy SL. Autoimmune Neurology: The Need for Comprehensive Care. Neurol Neuroimmunol Neuroinflamm. Published online June 15, 2021. doi: 10.1212 / NXI.0000000000001033
