Lea Alhilali, MD Profile picture
Neuroradiologist @HRInstitute_AZ. @BarrowNeuro. Striving to make learning neuroimaging and anatomy fun. If I can make you laugh, I can make you learn.

Aug 2, 2024, 7 tweets

1/Wish that your knowledge of autoimmune encephalitis was automatic?

Do you feel in limbo when it comes to the causes of limbic encephalitis?

Do you know the patterns of autoimmune encephalitis?

Here’s a thread with some hints to help you figure it all out!

2/Two pearls:
(1) Most common pattern is limbic encephalitis
(2) Small cell can cause any autoimmune pattern.

You can also remember the causes by the demographic:
🔸Young man: testicular
🔸Older: Small cell
🔸Woman with psychiatric symptoms: breast

3/Limbic encephalitis is the most common pattern

But it has many, many different causes

Remember--limbic involvement is shaped like a question mark!

So for limbic encephalitis, the cause remains a question bc the differential is so broad

Must question & clinically correlate!

4/Some other patterns to remember:

Multifocal = small cell and neuroendocrine

Remember:
🔸Small cell gives you mets everywhere = small encephalitis everywhere
🔸Neuroendocrine can arise from different places all over your body = encephalitis different places all over your brain

5/Central/Deep gray = malignant thymoma

Remember:
Thymus is located central and deep in your chest, so its pattern is central and deep!

6/Frontal = ovarian teratoma

Remember:
Ovaries are situated on the uterus right where the frontal lobes are situated on the brain!

7/Brainstem = testicular

Remember:
Brainstem hangs down from the cerebrum like the testicles

Hopefully, these hints will help you, so that the next time you see autoimmune encephalitis, you can be on autopilot!

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