Autoimmune Encephalitis: The Diagnosis of Exclusion
A 39-year-old male with no PMH presented to the ED with altered mental status (AMS), which progressed over a course of one week with worsening fatigue, decreased appetite, and dysphagia. Screening for toxic and infectious etiologies was unremarkable. Paraneoplastic antibodies, NMDA receptor antibodies, and autoimmune encephalitis panel were also negative. Likewise, CT of chest, abdomen, and pelvis showed no masses or malignancy. An extensive workup was only notable for bilateral posterior parietal and occipital lobe hyperintensities on MRI and pleocytosis with lymphocyte predominance on lumbar puncture. In this case report, the differential diagnoses for acute AMS in adults will be explored.
Le D, Yousef J, Soto RG. Autoimmune encephalitis: the diagnosis of exclusion. Paper presented at: The American Society of Anesthesiology Annual Meeting; 2021 Oct 8-12; San Diego, CA. Available at: https://www.abstractsonline.com/pp8/#!/9323/presentation/4982