From: Autoimmune epilepsy due to N-methyl-d-aspartate receptor antibodies in a child: a case report
Diagnosis of AEp requires the presence of the following two clinical criteria: |
1. Acute or subacute (< 12 weeks) onset of symptoms, and |
2. Exclusion of other causes (CNS infection, trauma, toxic, tumor, metabolic, previous CNS disease) |
The presence of at least one of the following supportive features would strengthen the suspicion of AEp: |
1. The presence of a well-defined clinical syndrome such as NMDAR or limbic encephalitis; |
2. CNS inflammation manifested by at least one of the following: |
a. CSF pleocytosis (defined as > 5 white cells/mm3) or presence of oligoclonal bands, elevated IgG index, or elevated neopterin (defined as > 30 nM); |
b. MRI abnormality compatible with an inflammatory or autoimmune encephalitis including increased signal in the mesio-temporal lobe (LE-like syndrome); or |
c. Inflammatory neuropathology on biopsy |
3. History of other antibody-mediated conditions (for example myasthenia gravis), organ-specific autoimmunity, or other autoimmune disorders; or |
4. Response to immunotherapy |