Svar Life Science

February 22, 2023

Time is Brain:  early diagnosis is vital  for Encephalitis

Today is World Encephalitis Day, and we are proud to join the encephalitis community and The Encephalitis Society to raise global awareness of encephalitis and the importance of early diagnosis.

This year the Encephalitis Society awareness campaign is focused on the importance of mental health during and following encephalitis.  Changes associated with encephalitis can take a toll on mental health, which must be considered when discussing encephalitis.

February 22, 2023

Time is Brain:  early diagnosis is vital  for Encephalitis

Today is World Encephalitis Day, and we are proud to join the encephalitis community and The Encephalitis Society to raise global awareness of encephalitis and the importance of early diagnosis.

This year the Encephalitis Society awareness campaign is focused on the importance of mental health during and following encephalitis.  Changes associated with encephalitis can take a toll on mental health, which must be considered when discussing encephalitis.
500K-2000K

People are affected by encephalitis globally each year1 

Long-term effects &
death rate

can be significantly reduced with early diagnosis and treatment1 

Barriers to AE diagnosis

include lack of specialists to interpret lab results and lack of availability of antibody tests1

ENCEPHALITIS AFFECTS THE BRAIN NETWORK CONNECTIVITY

Encephalitis is an often devastating disease where there is inflammation of the brain. Causes include infection (viral or bacterial)  or autoantibodies targeting extracellular domains of specific neuroglial markers, known as autoimmune encephalitis (AE).
 
Encephalitis affects the brain and how neuronal networks are connected. This can lead to various symptoms, including headaches, seizures, focal neurological signs, movement disorders, confusion, chronic fatigue, attention concentration, and memory issues. 
 
The acute phase of encephalitis can also trigger mental health difficulties such as personality/behavioral changes, delirium and psychosis.

 

EARLY DIAGNOSIS IS VITAL

The overlap of some encephalitis symptoms with other more common neurological or psychiatric manifestations can often make a diagnosis very challenging, which could risk a delay in correct diagnosis and prompt access to disease-modifying therapies.

Correctly diagnosing encephalitis is crucial since some treatments are effective when given early. That's why diagnosis is vital. Early diagnosis is essential to provide the patient with an early treatment to prevent disease progression. The longer the disease progresses, the more the likelihood of longer-term cognitive burden and mental health difficulties increases2.

Diagnosis requires a thorough history, physical exam, lab tests, brain imaging (MRI and CT scan), and EEG (measuring brain waves).

Specific tests are performed to identify the cause of encephalitis (infectious or autoimmune), such as microbiological tests to detect viruses or bacteria for infectious encephalitis and auto-antibody studies for AE.

Auto-antibody tests might include antibodies against; AMPA 1/2 receptors, CASPR2, DPPX, GABA B receptors, LGI-1, NMDA receptor, and VGKC.

MENTAL HEALTH AFTER ENCEPHALITIS

A new large international effort, supported by the Encephalitis Society, comprising self-reported data from 445 patients from 31 different countries, has shown that psychiatric symptoms are also common in post-acute stages of the disease, being anxiety, sleep and mood problems, unexpected crying, and aggression the most common  psychiatric symptoms3
 
In this large-scale study, other psychiatric symptoms, including suicidal thoughts, were also reported and did not differ between infectious and AE. Additionally, it has previously been reported that there is a higher rate of suicidal risk among those with encephalitis than among the rest of the population4. Within the different types of encephalitis, suicidal thoughts have been reported following different forms of encephalitis, such as NMDAR5,6, and other forms of autoimmune encephalitis7,8.
 
Therefore, it should be acknowledged that the potential for mental health issues is far from rare and can be a severe consequence of encephalitis, highlighting the relevance of early diagnosis and psychiatric care for these patients. 
 
Through World Encephalitis Day, the encephalitis society is aiming to not only raise awareness of these issues. To know more about The Encephalitis Society resources to help support those who may be facing mental health problems visit : Mental health and encephalitis | The Encephalitis Society

Find more answers related to
Autoimmune Encephalitis

Overview of Laboratory Tests & Algorithm - Autoimmune Encephalitis
Overview of Laboratory Tests - Autoimmune Encephalitis 2

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References:

  1. Encephalitis Society (2022) Encephalitis: an in-depth review and gap analysis of key variables affecting global disease burden.

  2. Ramanathan, S., Al-Diwani, A., Waters, P. & Irani, S. R. The autoantibody-mediated encephalitides: from clinical observations to molecular pathogenesis. J Neurol 268, 1689–1707 (2021).

  3. Abdat, Y. et al. Mental health outcomes of encephalitis: an international web-based study, http://medrxiv.org/content/early/2023/02/07/2023.02.03.23285344.abstract .

  4. Erlangsen, A. et al. Association Between Neurological Disorders and Death by Suicide in Denmark. JAMA 323, 444–454 (2020).

  1. Zhang, L. et al. Suicidality is a common and serious feature of anti-N-methyl-D-aspartate receptor encephalitis. J Neurol 264, 2378–2386 (2017).

  2. Tellez-Martinez, A. et al. Suicidal thoughts and behaviors in anti-NMDAR encephalitis: psychopathological features and clinical outcomes. The Journal of Neuropsychiatry and Clinical Neuroscience.

  3. Fusar-Poli, L., Gabbiadini, A., Battaglia, G., Signorelli, M. S. & Aguglia, E. The Management of Long-Term Psychiatric Sequelae in a Young Woman Who Suffered From Suspected Autoimmune Limbic Encephalitis. Clinical Medicine Insights: Psychiatry 11, 1179557320962520 (2020).

  4. Ebaugh, F. G. Neuropsychiatric sequelae of acute epidemic encephalitis in children. 1923. J Atten Disord 11, 336–338; discussion 339-340 (2007).

 

WANT TO KNOW MORE?
For more information about encephalitis, patient stories, and how you can contribute to World Encephalitis Day, please go to: https://www.encephalitis.info.