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18F‐fluoro‐deoxyglucose position emission tomography (18F‐FDG‐PET) has been proven as a sensitive and reliable tool for diagnosis of autoimmune encephalitis (AE). More attention was paid to this kind of imaging because of the shortage of MRI, EEG, and CSF findings. FDG‐PET has been assessed in a few small studies and case reports showing apparent abnormalities in cases where MRI does not. Here, we summarized the patterns (specific or not) in AE with different antibodies detected and the clinical outlook for the wide application of FDG‐PET considering some limitations. Specific patterns based on antibody subtypes and clinical symptoms were critical for identifying suspicious AE, the most common of which was the anteroposterior gradient in anti‐ N ‐methyl‐ d ‐aspartate receptor (NMDAR) encephalitis and the medial temporal lobe hypermetabolism in limbic encephalitis. And the dynamic changes of metabolic presentations in different phases provided us the potential to inspect the evolution of AE and predict the functional outcomes. Except for the visual assessment, quantitative analysis was recently reported in some voxel‐based studies of regions of interest, which suggested some clues of the future evaluation of metabolic abnormalities. Large prospective studies need to be conducted controlling the time from symptom onset to examination with the same standard of FDG‐PET scanning. [ABSTRACT FROM AUTHOR]

Objectives: To establish a model in order to predict the functional outcomes of patients with anti‐leucine‐rich glioma‐inactivated 1 (LGI1) encephalitis and identify significant predictive factors using a random forest algorithm. Methods: Seventy‐nine patients with confirmed LGI1 antibodies were retrospectively reviewed between January 2015 and July 2020. Clinical information was obtained from medical records and functional outcomes were followed up in interviews with patients or their relatives. Neurological functional outcome was assessed using a modified Rankin Scale (mRS), the cutoff of which was 2. The prognostic model was established using the random forest algorithm, which was subsequently compared with logistic regression analysis, Naive Bayes and Support vector machine (SVM) metrics based on the area under the curve (AUC) and the accuracy. Results: A total of 79 patients were included in the final analysis. After a median follow‐up of 24 months (range, 8–60 months), 20 patients (25%) experienced poor functional outcomes. A random forest model consisting of 16 variables used to predict the poor functional outcomes of anti‐LGI1 encephalitis was successfully constructed with an accuracy of 83% and an F1 score of 60%. In addition, the random forest algorithm demonstrated a more precise predictive performance for poor functional outcomes in patients with anti‐LGI1 encephalitis compared with three other models (AUC, 0.90 vs 0.80 vs 0.70 vs 0.64). Conclusions: The random forest model can predict poor functional outcomes of patients with anti‐LGI1 encephalitis. This model was more accurate and reliable than the logistic regression, Naive Bayes, and SVM algorithm. [ABSTRACT FROM AUTHOR]

Objectives: Early‐onset anti‐N‐methyl‐D‐aspartate receptor encephalitis (anti‐NMDARE) differs from late‐onset anti‐NMDARE regarding clinical characteristics. Until recently, research focusing on prognosis of elder adults has been scarce and showed inconsistent results. This study aims to evaluate the prognosis of late‐onset anti‐NMDARE in China. Materials & Methods: One hundred and twelve adults diagnosed as anti‐NMDARE in four hospitals in China were reviewed retrospectively. Outcome data were assessed using modified Rankin Scale (mRS) score in short term (3 months after discharge) and long term (≥12 months after discharge). The relapse rate was also computed. Multivariable logistic regression was used to evaluate whether there are substantial differences in functional outcomes and recurrence rate across two groups. Results: Of the 112 patients with anti‐NMDARE, 81 (72.3%) were early‐onset disease and 31 (27.7%) were late‐onset disease. Of these, all had short‐term follow‐up and 70 completed long‐term follow‐up. Late‐onset anti‐NMDARE group showed better short‐term (OR 2.70, 95% CI 1.09–6.71) and long‐term prognoses (OR 10.25, 95% CI 1.90–55.15). Recurrence rates were statistically different between the groups (OR 4.25, 95% CI 1.22–14.75). Conclusion: The prognosis for anti‐NMDARE in China was poorer for older adults relative to younger adults. The relapse rates were higher in late‐onset group compared to early‐onset group. [ABSTRACT FROM AUTHOR]

Objectives: To examine the clinical characteristics of autoimmune encephalitis associated with the glutamate decarboxylase 65 (GAD 65) antibody. Materials and methods: Medical records of all patients that diagnosed with GAD 65 antibody‐associated encephalitis were retrospectively analyzed. Data regarding demographics and symptoms, neurological signs, laboratory and imaging results, treatment and prognosis were collected. Results: We collected a total of seven patients, mainly young or middle‐aged women with a subacute or chronic course. The main clinical symptoms mainly included chronic epilepsy, cerebellar ataxia, stiff‐person syndrome, and limbic encephalitis. Three of seven (43%) patients had high CSF (cerebrospinal fluid) protein levels. Oligoclonal IgG bands (including IgG 1) and 24 hours intrathecal synthesis of IgG were detected in CSF and serum in six patients, five patients (83%) reported increased distribution of oligoclonal IgG bands (including IgG 1) and 24 hours intrathecal synthesis of IgG in serum and CSF. And six of seven patients (86%) had abnormal thyroid function or were positive for thyroid antibodies. By electroencephalogram examination, sharp or slow waves in the temporal region were often observed for six of seven patients (86%). Abnormal imaging signals (six of seven patients, 86%) of the temporal lobe and hippocampus were detected by brain magnetic resonance imaging, and decreased metabolism of the temporal lobe was detected by positron emission tomography/computed tomography (six of six patients, 100%). These patients were mainly treated with corticosteroid and gamma globulin. The clinical symptoms of the patients were alleviated. Conclusions: The course of GAD 65 antibody‐associated encephalitis is longer than other autoimmune encephalitides. The clinical symptoms of GAD 65 autoimmune encephalitis mainly manifested as chronic epilepsy, cerebellar ataxia, stiff‐person syndrome, and limbic encephalitis, and combined with or without thyroid autoimmune diseases, type 1 diabetes, and thymoma. A comprehensive understanding of the disease is a way to prevent misdiagnosis and delayed treatment. [ABSTRACT FROM AUTHOR]