Your Guide to Autoimmune Encephalitis
Autoimmunity is when the immune system goes haywire and begins detecting its own cells as harmful, thus prompting the body to attack itself. This can manifest in many forms, often leading to chronic inflammation and other pain.
Autoimmune encephalitis is a serious autoimmune condition that attacks the central nervous system and neural areas.
While people with autoimmune conditions can help limit their flare-ups through diet changes and other lifestyle changes, autoimmune encephalitis often requires more significant first-line treatments — which we’ll outline below — and in many cases, people see major improvements in this disease.
What is Autoimmune Encephalitis?
Autoimmune encephalitis is a serious autoimmune condition wherein healthy brain cells are attacked by the immune system’s antibodies, which improperly identify the body’s cells as external invaders. It is a type of inflammation in the brain due to these attacks, which may also target the spinal cord.
This disease has been recognized relatively recently, and in some cases has been associated with ovarian tumors. Due to its recency and the already complex nature of autoimmune diseases, autoimmune encephalitis can be difficult to diagnose and treat. However, it is not rare by any means, and new research and developments are rapidly emerging.
This disease most commonly affects people between the ages of 13 to 50, but often occurs in younger people and is generally found in women more than men. That being said, it can also affect children, leading to PANS (pediatric acute-onset neuropsychiatric syndrome). Luckily, PANS treatments are available.
Each year, autoimmune encephalitis affects 10-15 people per 100,000. You may be more at risk for an autoimmune disease if you have a family history of autoimmunity, so it’s important to understand your family health history and keep an eye out for symptoms.
What Causes Autoimmune Encephalitis?
Previously, infections appeared to be the most commonly known cause of autoimmune encephalitis, caused by viruses carried by insects such as mosquitoes, ticks, and other animals. Some examples include West Nile, the Zika virus, La Crosse virus, and St. Louis virus. It could also be caused by exposure to streptococcus and herpes simplex.
However, within the past 20 years, neuroglial proteins within patients have shifted.
Types of autoimmune encephalitis
We now know that there are multiple types of autoimmune encephalitis. According to the Autoimmune Encephalitis Alliance, there are 11 types.
Anti-NMDA receptor encephalitis
Most often affecting children and young adults, this condition attacks the NMDA receptor in the brain, which is integral in helping with memory formation. It begins with flu-like symptoms, progressing rapidly over days or weeks, and often leads to hospitalization and intensive care unit admission.
While recovery can be slow, approximately 80% of patients improve with immunotherapy treatment.LGI1-antibody encephalitis
This disease is most common in patients over 50 years old, and disproportionately men. It wasn’t until 2010 that it was found to target LGI1 cells, a protein in the brain that helps regulate communication between neurons, particularly in the temporal lobe where memory and emotion are centered.
Symptoms often include seizures and cognitive impairment. Although difficult to diagnose, immunotherapy treatment shows improvements in more than 95% of patients.CASPR2-antibody encephalitis
This autoimmune condition can affect people of all ages, but is found more often in men. Discovered very recently in 2011, CASPR2-antibody encephalitis affects autoantibodies that block interactions within other cells to ensure they can rest and not fire repetitively.
As a result of these cells being affected, symptoms include muscle twitches, irregular heart rate/blood pressure, memory problems, difficulty with movement, and more. As with other forms of autoimmune encephalitis, immunotherapy can help improve symptoms.Anti-GABAA receptor encephalitis
This type of autoimmune condition can affect people of all ages and sexes, characterized by frequent seizures and clear MRI abnormalities, along with changes in cognition. First-line immunotherapy, anti-epileptic drugs, and supportive treatments can be very effective in completely treating this autoimmune disease.Anti-GABAB receptor encephalitis
Affecting mainly men, this autoimmune disease causes spontaneous and frequent seizures (up to 5 per day), and is also linked to lung cancer. It also tends to lead to behavioral issues and changes in personality.Anti-DPPX encephalitis
This type of encephalitis affects majority middle-aged men, and is relatively new to the medical field, first identified in 2013. DPPX proteins generate and regulate electrical impulses in both the gut and nervous systems.
As a result of this disease, people are affected with severe diarrhea or constipation that can lead to weight loss. As it progresses, memory difficulties, hallucinations, and more can occur. Immunotherapy is an effective treatment, though some people can relapse.Anti-GAD65 limbic encephalitis
More prevalent in women, this disease can affect people of all ages, but symptoms tend to present themselves around the age of 30. It can cause sudden seizures and amnesia, and while there may be some psychiatric symptoms, it is much less common than other types of autoimmune encephalitis conditions.Anti-AMPAR encephalitis
AMPAR are important in memory and learning, and this rare type of encephalitis affects them. It is often associated with an underlying tumor, and affects women slightly more than men. Those affected may experience disorientation, confusion, and memory loss.Anti-IgLON5 disease
This type of disease differs from other types of autoimmune encephalitis, particularly because it’s characterized by a sleep disorder and with a slower progression. It is also quite rare, and affects people who are generally older (62+). Along with sleep issues, many people experience cognitive dysfunction and urinary incontinence.GlyR antibody encephalitis
Not tied to a specific age or sex, GlyR antibody encephalitis affects both men and women of all ages proportionately. Symptoms often include spasms, rigidness in the neck, and stiffness in other muscles that can lead to difficulty walking. Immunotherapies are used to treat this type of encephalitis.Hashimoto encephalopathy
This rare syndrome is associated with Hashimoto's disease and hypothyroidism or hyperthyroidism, and isn’t yet well understood. More common in women, it occurs when antibodies bind to the thyroid rather than the central nervous system, causing seizures, spasms, and muscle jerks, along with personality changes and movement disorders.
Symptoms of Autoimmune Encephalitis
As outlined above, there are numerous types of autoimmune encephalitis that present differing symptoms. However, many of them overlap.
Common symptoms of this autoimmune condition include:
Cognitive impairment (e.g. sudden decline in work or academic abilities)
Psychosis (e.g. hallucinations, disorientation, confusion, euphoria, fear)
Headaches
Seizures
Memory impairment
Panic attacks
Loss of mobility (e.g. poor balance)
Sudden changes in behavior (e.g. compulsivity, inappropriate sexual behavior)
Many types of autoimmune encephalitis can be confirmed via MRI, and serious symptoms such as those listed above should be brought to the attention of your healthcare provider immediately.
Treatments Available
Prompt immunotherapy is key in managing many types of autoimmune encephalitis.
Immunotherapy is actually a type of cancer treatment, but because it works to rebuild the immune system, it also works for autoimmune encephalitis. It uses the body’s own immune cells to help bolster the body’s immune system.
Along with immunotherapy, first-line treatments include steroids provided through IV, corticosteroids (an immunosuppressant that prevents the immune system from making additional harmful autoantibodies), IV immunoglobulin, and plasma exchange.
Second-line immunotherapy treatments include rituximab (antibody infusion), and cyclophosphamide – a chemotherapy drug that slows the growth of immune system cells.
Other types of treatments are available that work in different ways to suppress the immune system and target specific cells. The best information and personalized treatment plan will come through discussions with your healthcare provider.
The Role of Functional Medicine in Autoimmunity
Functional medicine focuses on addressing the root cause of a disease, focusing on a holistic view of a patient including their physical, mental, emotional, and sometimes spiritual health. Functional medicine doctors may focus on your sleep patterns, exercise habits, nutrition, and other factors in your life.
While it is important to also see medical treatment, functional medicine can be helpful in diagnosing and treating autoimmune diseases. At Genesis Functional Wellness, we investigate underlying dysfunctions of your symptoms, and take a full view of your health through customized testing and more.