Autoimmune epilepsy can be diagnosed by using specific criteria.
Screening criteria - both of the following:
(1) acute or subacute onset of symptoms (< 12 weeks)
(2) exclusion of other causes (infection, trauma, toxic, tumor, metabolic, previous CNS disease)
If the screen is positive, then one or more of the following features should be present in autoimmune epilepsy:
(1) presence of a well-defined clinical syndrome (limbic encephalitis; NMDAR encephalitis)
(2) evidence of CNS inflammation - one or more of the following:
(2a) CSF pleocytosis with > 5 WBC per microliter
(2b) oligoclonal bands or elevated IgG index in the CSF
(2c) elevated CSF neopterin (> 30 mmol/L)
(2d) MRI abnormality consistent with inflammatory or autoimmune encephalitis
(2e) inflammation present in a brain biopsy
(3) history of an antibody-mediated condition (myasthenia gravis, autoimmune thyroid disease, celiac disease, multiple sclerosis, SLE, etc)
(4) response to immunotherapy
