Presenting and residual movement disorders in all-cause autoimmune encephalitis.
Presenting and residual movement disorders in all-cause autoimmune encephalitis.
A plain-language reading has not been prepared for this paper yet.
Original abstract
BACKGROUND: Movement disorders are among the most common autoimmune encephalitis (AE) symptoms, yet their detailed phenomenology and impact remain underexplored. OBJECTIVE: We evaluated the prevalence, characteristics, and impact of movement disorders at presentation and latest follow-up in all-cause AE. METHODS: We retrospectively reviewed AE patients from a tertiary neuroimmunology clinic. Movement disorders were characterized at presentation and latest follow-up and compared between antibody-positive and antibody-negative disease. Outcomes were assessed using the Modified Rankin Scale (mRS) and the Clinical Assessment Scale in Autoimmune Encephalitis (CASE). RESULTS: Sixty-eight patients were included (53% female, average age 54 years, SD 20.1, 50% antibody-positive). Thirty-seven (52%) patients had movement disorders at presentation, of whom 23 (34%) had residual movement disorders at latest follow-up. The most common movement disorders at presentation included dystonia, ataxia, stereotypies, and catatonia. The most common residual movement disorders included ataxia, dystonia and parkinsonism. Antibody-negative patients were less likely to present with movement disorders (p = 0.02). Patients with movement disorders at presentation were more likely to be women (p = 0.04), had longer time to first outpatient visit (p = 0.04), and had higher mRS score and CASE Score at presentation (mRS 3.32 vs 2.52, p = 0.015, CASE 6.27 vs 4.39, p = 0.094) and at follow-up (mRS 2.19 vs 1.25, p = 0.017, CASE 2.53 vs 1.28, p = 0.029). CONCLUSIONS: More than half the patients with movement disorders had residual symptoms. Antibody-negative patients were less likely to present with movement disorders. Presence of movement disorders at presentation was associated with poorer overall outcomes.