Preprint Review Version 1 This version is not peer-reviewed

Autoimmune Encephalitis and Paraneoplastic Neurological Syndromes with Progressive Supranuclear Palsy-Like Manifestations

Version 1 : Received: 6 September 2024 / Approved: 9 September 2024 / Online: 10 September 2024 (12:46:26 CEST)

How to cite: Yamahara, N.; Takekoshi, A.; Kimura, A.; Shimohata, T. Autoimmune Encephalitis and Paraneoplastic Neurological Syndromes with Progressive Supranuclear Palsy-Like Manifestations. Preprints 2024, 2024090724. https://doi.org/10.20944/preprints202409.0724.v1 Yamahara, N.; Takekoshi, A.; Kimura, A.; Shimohata, T. Autoimmune Encephalitis and Paraneoplastic Neurological Syndromes with Progressive Supranuclear Palsy-Like Manifestations. Preprints 2024, 2024090724. https://doi.org/10.20944/preprints202409.0724.v1

Abstract

Advances in diagnostic procedures have led to an increasing rate of diagnosis of autoimmune encephalitis or paraneoplastic neurological syndrome (AE/PNS) among patients with progressive supranuclear palsy (PSP)-like manifestations. The antibodies involved in these conditions include anti-IgLON5, -Ma2, and -Ri antibodies, each of which has a characteristic clinical presentation. The steps in the diagnosis of AE/PNS in patients with PSP-like manifestations include (i) suspicion of AE/PNS based on clinical presentations atypical of PSP and (ii) antibody detection measures. Methods used to identify antibodies include a combination of tissue-based assays and confirmatory tests. The primary confirmatory tests include cell-based assays and immunoblotting (line or western blot). Treatments can be divided into immunotherapy and tumor therapies, the former of which includes acute and maintenance therapies comprising corticosteroids, intravenous immunoglobulins, plasmapheresis, rituximab, and cyclophosphamide. One of the major challenges of diagnosis is that existing reports on PSP-like patients with AE/PNS include only case reports, with the majority discussing antibodies other than anti-IgLON5 antibody. As such, more patients need to be evaluated to establish the relationship between antibodies and PSP-like manifestations.

Keywords

progressive supranuclear palsy; autoimmune encephalitis; paraneoplastic neurological syndrome

Subject

Medicine and Pharmacology, Neuroscience and Neurology

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