Department of Neurology, Division of Neuro-Epidemiology, New York University School of Medicine, New York, NY 10016, USA; School of Public Health, City University of New York, New York, NY, USA.
Neurol Clin. 2019 May;37(2):359-381. doi: 10.1016/j.ncl.2019.01.015. Epub 2019 Mar 16.
Autoimmune encephalitis is a severe inflammatory disorder of the brain with diverse causes and a complex differential diagnosis. Recent advances in the past decade have led to the identification of new syndromes and biological markers of limbic encephalitis, the commonest presentation of autoimmune encephalitis. The successful use of serum and intrathecal antibodies to diagnose affected patients has resulted in few biopsy and postmortem examinations. In those available, there can be variable infiltrating inflammatory T cells with cytotoxic granules in close apposition to neurons, consistent with an inflammatory autoimmune basis, but true vasculitis is rarely seen. The exception is Hashimoto encephalopathy.
自身免疫性脑炎是一种严重的大脑炎症性疾病，病因多样，鉴别诊断复杂。在过去十年中的最新进展，导致了边缘性脑炎（最常见的自身免疫性脑炎表现形式）的新综合征和生物标志物的鉴定。血清和鞘内抗体的成功应用，使得对受影响患者的诊断很少需要进行活检和尸检。在现有的检查中，可见到大量具有细胞毒性颗粒的浸润性炎症 T 细胞与神经元紧密相邻，这与炎症性自身免疫基础相一致，但很少见到真正的血管炎。桥本脑病是一个例外。
