Graus et al provided criteria for the diagnosis of several types of autoimmune encephalitis, including autoimmune limbic encephalitis. The authors are from multiple institutions from around the world.
Patient selection: encephalitis
Criteria for autoimmune limbic encephalitis - all of the following:
(1) subacute onset (< 3 months) of deficits in working memory and/or psychiatric symptoms suggesting involvement of the limbic system
(2) bilateral brain abnormalities identified on T2-weighted fluid-attenuated inversion recovery MRI highly restricted to the medial temporal lobes (OR similar on 18F-FDG PET scan)
(3) one or both of the following:
(3a) CSF white blood cell count > 5 per microliter
(3b) EEG with epileptic or slow-wave activity involving the temporal lobes
(4) reasonable exclusion of other explanations
where:
• The patient may have confusion and seizures.
• The CSF may show elevated IgG index or oligoclonal bands.
If one of the first 3 criteria is missing, then the diagnosis can be made with detection of antibodies against cell surface, synaptic or onconeural proteins.
