- Antibody mediated, multiple of which have been implicated, including anti-nmda
- Also paraneoplastic mediated anti-bodies
- Teratoma, which may be unknown at time of presentation w/encephalitis)
- Sub-acute, progressive changes in personality and decline in functional status (usually over weeks; sometimes months)
- Symptoms can wax and wane
- Confusion, bizarre behavior
- Autonomic instability
- Seizures, unusual movements
- Other neurologic deficits
- History, exam, labs, imaging to exclude other causes (other neuro or metabolic processes, primary psychiatric d/o)
- LP, MRI of brain; sometimes EEG
- Auto-antibody and para-neoplastic mediated antibody panels (CSF and Serum) can be helpful