{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:42:37Z","timestamp":1788309757323,"version":"build-2803163510"},"reference-count":17,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,5,19]],"date-time":"2021-05-19T00:00:00Z","timestamp":1621382400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,5,19]],"date-time":"2021-05-19T00:00:00Z","timestamp":1621382400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Neurol"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Autoimmune encephalitis (AE) is now considered a main, potentially curable cause of encephalitis, but remains conspicuously underreported from South Asia. We studied the clinical characteristics in relation to their antibody status and outcomes of patients presenting with AE in Sri Lanka.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Patients admitting to government hospitals who were clinically suspected of AE by an on-site neurologist were prospectively recruited over a period of 12\u2009months. Sera and cerebrospinal fluid were tested for NMDAR, AMPAR1, AMPAR2, LGI1, CASPR2, GABARB1\/B2 antibodies (Ab) using commercial cell-based assays. Demographic, clinical and laboratory data were compiled into an investigator-administered proforma. Patients were reviewed at 1 year follow up either in person or via telephone.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>One-hundred and forty-two patients from 21 of 25 districts in Sri Lanka (median age\u2009=\u200920.5\u2009years; range 1\u201386\u2009years; females\u2009=\u200961.3%) were recruited. Of them, 65 (45.8%; median age\u2009=\u200919\u2009years; range 1\u201386\u2009years; females\u2009=\u200964.6%) fulfilled diagnostic criteria for probable NMDAR-antibody encephalitis (NMDARE) and 6 (4.2%; median age\u2009=\u200944\u2009years; range 28\u201371\u2009years; females\u2009=\u200983.3%) limbic encephalitis (LE). Abnormal behaviour (95.3%), seizures (81.5%) and movement disorders (69.2%) were the most frequent clinical manifestations of probable NMDARE. NMDAR-antibodies were detectable in 29 (44.6%) and not detectable in 36 in CSF of probable-NMDARE patients. Abnormal EEG was more frequent (<jats:italic>p<\/jats:italic>\u2009=\u20090.003) while a worse outcome (OR\u2009=\u20092.78; 95% CI\u2009=\u20090.88\u20139.09) and deaths (OR\u2009=\u20092.38; 95% CI\u2009=\u20090.67\u20138.33) were more likely in antibody-negative than antibody-positive probable-NMDARE. Most patients with LE had amnesia (50%) and\/or confusion (100%) with agitation (83.3%) and seizures (100%) but none had detectable antibodies to any of the antigens tested.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>NMDARE is the commonest type of AE among South Asians as is the case worldwide. Clinical presentations of NMDARAb-positive and NMDARAb-negative AE patients do not significantly differ but EEG may be a\u00a0useful marker of an autoimmune basis for psychiatric symptoms.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12883-021-02232-6","type":"journal-article","created":{"date-parts":[[2021,5,19]],"date-time":"2021-05-19T07:03:00Z","timestamp":1621407780000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Autoimmune encephalitis in a South Asian population"],"prefix":"10.1186","volume":"21","author":[{"given":"Nilanka","family":"Wickramasinghe","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dhanushka","family":"Dasanayake","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neelika","family":"Malavige","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajiva","family":"de Silva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thashi","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,5,19]]},"reference":[{"issue":"12","key":"2232_CR1","doi-asserted-by":"publisher","first-page":"835","DOI":"10.1016\/S1473-3099(10)70222-X","volume":"10","author":"J Granerod","year":"2010","unstructured":"Granerod J, Ambrose HE, Davies NW, Clewley JP, Walsh AL, Morgan D, et al. Causes of encephalitis and differences in their clinical presentations in England: a multicentre, population-based prospective study. Lancet Infect Dis. 2010;10(12):835\u201344. https:\/\/doi.org\/10.1016\/S1473-3099(10)70222-X.","journal-title":"Lancet Infect Dis"},{"issue":"9","key":"2232_CR2","doi-asserted-by":"publisher","first-page":"840","DOI":"10.1056\/NEJMra1708712","volume":"378","author":"J Dalmau","year":"2018","unstructured":"Dalmau J, Graus F. Antibody-mediated encephalitis. N Engl J Med. 2018;378(9):840\u201351. https:\/\/doi.org\/10.1056\/NEJMra1708712 PMID: 29490181.","journal-title":"N Engl J Med"},{"issue":"2","key":"2232_CR3","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1016\/S1474-4422(12)70310-1","volume":"12","author":"MJ Titulaer","year":"2013","unstructured":"Titulaer MJ, McCracken L, Gabilondo I, Armangue T, Glaser C, Iizuka T, et al. 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Written informed consent was obtained from either the patient or guardian.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no relevant competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"203"}}