{
  "abstract": "Seronegative autoimmune encephalitis (SNAIE) is a challenging condition characterized by diagnostic uncertainty, delayed treatment, and often poor outcomes. Accurate diagnosis is essential to optimize management and avoid unnecessary interventions.This study reviewed IVIG requests under the working diagnosis of SNAIE at Nottingham from January 2018 to January 2024. Clinical data were extracted from health records, and final diagnoses were assessed using the 2016 diagnostic criteria for SNAIE by an encephalitis panel.A total of 25 suspected cases were identified, comprising 19 females and 6 males, with an average age of 36.36 years. Of these, 48% were reclassified with alternative diagnoses, including Hashimoto encephalitis, mitochondrial disease, febrile infection-related epilepsy syndrome, post-COVID encephalomyelitis, post-vaccine encephalomyelitis, cerebral vasculitis, Lewy body dementia, seronegative encephalitis (not meeting SNAIE criteria), and status epilepticus of unknown cause. Psychosis was more prevalent in SNAIE cases, while ataxia and MRI abnormalities were common in alternative diagnoses. Limbic involvement predominated in SNAIE, whereas cortical abnormalities were more frequent in other cases. No difference was seen in CSF study.The findings highlight the need for precise diagnostic protocols to improve accuracy and reduce IVIG misuse. Advanced imaging and novel biomarkers may enhance diagnostic precision, optimizing patient outcomes and minimizing treatment-related risks.b.shao@nhs.net",
  "authors": [
    {
      "affiliations": [
        "Academic Neurology, University of Nottingham",
        "Department of Academic Neurology, Nottingham University Hospitals NHS trust"
      ],
      "name": "Shao Beili"
    },
    {
      "affiliations": [
        "Department of Academic Neurology, Nottingham University Hospitals NHS trust"
      ],
      "name": "Teoh Crystal"
    },
    {
      "affiliations": [
        "Department of Academic Neurology, Nottingham University Hospitals NHS trust"
      ],
      "name": "Ibrahim Afa"
    },
    {
      "affiliations": [
        "Department of Academic Neurology, Nottingham University Hospitals NHS trust",
        "Sir Peter Mansfield Imaging Centre, University of Nottingham"
      ],
      "name": "Hosseini Akram A"
    },
    {
      "affiliations": [
        "Department of Academic Neurology, Nottingham University Hospitals NHS trust"
      ],
      "name": "Gran Bruno"
    },
    {
      "affiliations": [
        "Department of Academic Neurology, Nottingham University Hospitals NHS trust"
      ],
      "name": "Tanasescu Radu"
    }
  ],
  "title": "228 Reappraisal of diagnosis in seronegative AIE: 6-year experience of tertiary neuroscience centre",
  "uid": "fdbde0b9-6fa9-58f1-8b26-722bcfd2bcae"
}