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The clinical syndromes have phenotypes which are often highly characteristic of their associated antigen-specific autoantibody. For example, the constellation of psychiatric features and the multi-faceted movement disorder observed in patients with NMDAR antibodies are highly distinctive, as are the faciobrachial dystonic seizures observed in close association with LGI1 antibodies. These typically tight correlations may be conferred by the presence of autoantibodies which can directly access and modulate their antigens in vivo. AE remains an under-recognised clinical syndrome but one where early and accurate detection is critical as prompt initiation of immunotherapy is closely associated with improved outcomes. In this review of a rapidly emerging field, we outline molecular observations with translational value. We focus on contemporary methodologies of autoantibody detection, the evolution and distinctive nature of the clinical phenotypes, generalisable therapeutic paradigms, and finally discuss the likely mechanisms of autoimmunity in these patients which may inform future precision therapies.<\/jats:p>","DOI":"10.1007\/s00415-019-09590-9","type":"journal-article","created":{"date-parts":[[2019,10,26]],"date-time":"2019-10-26T09:03:46Z","timestamp":1572080626000},"page":"1689-1707","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":68,"title":["The autoantibody-mediated encephalitides: from clinical observations to molecular pathogenesis"],"prefix":"10.1007","volume":"268","author":[{"given":"Sudarshini","family":"Ramanathan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Al-Diwani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Waters","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7667-9748","authenticated-orcid":false,"given":"Sarosh R.","family":"Irani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,10,26]]},"reference":[{"issue":"3","key":"9590_CR1","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1093\/brain\/91.3.481","volume":"91","author":"JA Corsellis","year":"1968","unstructured":"Corsellis JA, Goldberg GJ, Norton AR (1968) \u201cLimbic encephalitis\u201d and its association with carcinoma. 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AAD is the recipient of a Wellcome Trust clinical research training fellowship (205126\/Z\/16\/Z) and of a 2017 British Medical Association (BMA) Foundation Margaret Temple grant, and is supported by the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre and NIHR Oxford Health Biomedical Research Centre. SRI is supported by the Wellcome Trust (104079\/Z\/14\/Z), the UCBOxford University Alliance, BMA Research Grants- Vera Down grant (2013) and Margaret Temple (2017) and Epilepsy Research UK (P1201). The research was funded \/supported by the National Institute for Health Research (NIHR) Oxford Biomedical Research Centre (BRC; The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health). SRI is a coapplicant and receives royalties on patent application WO\/2010\/046716 (U.K. patent no., PCT\/GB2009\/051441) entitled 'Neurological Autoimmune Disorders'. The patent has been licensed to Euroimmun AG for the development of assays for LGI1 and other VGKC-complex antibodies. He has received honoraria from UCB, MedImmun, ADC therapeutics and Medlink Neurology. PW is a named inventor on patents for antibody assays and has received royalties. He has received honoraria from Biogen Idec, Mereo Biopharma, Retrogenix, UBC and Euroimmun AG; travel grants from the Guthy-Jackson Charitable Foundation; and research funding from Euroimmun AG.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}}]}}