A comprehensive approach to care is important for patients with autoimmune neurologic disorders. In a review article published in Neurology, study authors discussed the importance of long-term, comprehensive care for this population.
Autoimmune neurology is a rapidly developing subspecialty in modern neurology driven by continuing autoantibody discoveries and increasing recognition of autoimmunity as the basis of neurologic conditions. This review focused on adult-onset autoimmune encephalitis, but applies to other autoimmune neurologic disorders, including those involving the peripheral and autonomic nervous systems.
The initial diagnosis of autoimmune encephalitis may be delayed as patients may present with various symptoms to disciplines other than neurology. While consensus criteria for autoimmune encephalitis can help with the diagnosis, subtle or atypical presentations may be more challenging.
In most cases, autoimmune encephalitis requires specialized care with advanced diagnostic imaging and treatment by providers with experience in managing autoimmune encephalitis. While the disease can be severe, significant recovery is expected in most cases.
The Clinical Assessment Scale in Autoimmune Encephalitis, which is based on 9 items, may help in overcoming some of the limitations in the initial assessment of autoimmune encephalitis. Additionally, the NMDAR Encephalitis One-Year Functional Status score was created to predict functional status for patients.
There are several benefits for targeted interventions at the time of discharge, including alleviating burden on family members, reducing hospital readmissions and improving patient outcomes. Follow-up appointments should be arranged for close monitoring, and these can be extended according to the clinical status of the patient.
A multidisciplinary clinical team is valuable and can provide guidance and develop a care plan with data showing improved patients’ care and quality of life with coordinated clinics.
Multidisciplinary autoimmune neurology care should be led by a neurologist with expertise in autoimmune neurological disorders, and should also include experts from other fields, such as psychiatry, neuropsychology, rehabilitation services, other neurology subspecialties, and additional medical subspecialties, as needed. Primary care physicians play an essential role in the support 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 coordinated among clinicians while anticipating the needs of the patients and caregivers,” concluded the review authors.
Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.
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