Abstract
Objectives Autoimmune encephalitis (AE) is an uncommon neuroinflammatory disorder requiring prompt diagnosis and treatment to improve patient outcomes. Movement disorders (MDs) occur in AE but their prevalence, classification and prognostic significance in AE is not well defined.
Methods We conducted a systematic review and random-effects meta-analysis to assess the prevalence of MDs as a whole as well as the different types of MDs (such as chorea, dyskinesia, ataxia and faciobrachial dystonic seizure) in AE and its subtypes. We included publications that had 10 or more cases, and focused on adults (18 years or older). We used the following four electronic databases: Medline (Ovid), EMBASE (Ovid), APA Psychinfo and Cochrane library.
Results A total of 1192 titles and abstracts were reviewed. Thirty-seven studies, comprising 2663 unique patients, were included in the final meta-analysis. At least one kind of movement disorder was present in 40% of the entire AE cohort, 53% in anti NMDA, 30% in anti LGI1, 33% in anti CASPR2, and 13% in anti GABAR antibody mediated AE. Dyskinesias were the commonest type of MD in anti NMDA antibody mediated AE and faciobrachial dystonic seizures were most prevalent in anti LGI1 antibody mediated AE. Patients with a movement disorder tended to have higher mortality.
Conclusion Movement disorders are often present in AE. Different AE subtypes have different MD profiles. The presence of MDs appears to have implications for patient outcome. Identifying MDs may assist the early diagnosis and management of AE.
