# Clinical Characteristics and Neuroimaging Correlations in Autoimmune Encephalitis: A Report of Two Cases

## TL;DR

This paper reports two young cases of autoimmune encephalitis, highlighting the importance of neuroimaging and CSF analysis for diagnosis and treatment challenges in resource-limited settings.

## Contribution

The paper presents the first reported cases of autoimmune encephalitis in the city, emphasizing clinical and diagnostic insights.

## Key findings

- Autoimmune encephalitis cases in young patients showed behavioral changes, altered consciousness, and seizures.
- MRI and anti-NMDA antibody detection were crucial for diagnosis.
- Treatment with immunoglobulins and corticosteroids led to cognitive sequelae post-discharge.

## Abstract

Autoimmune encephalitis is an infrequent pathological occurrence documented within our local context. When clinical suspicion arises, employing electroencephalogram and brain magnetic resonance imaging (MRI) proves valuable. However, for conclusive diagnosis confirmation, lumbar puncture for cerebrospinal fluid (CSF) analysis is indispensable. Managing this condition involves a combination of immunosuppression and, when necessary, tumor resection. We document the initial cases reported in our city, featuring two young patients without significant pre-existing conditions. Patients initially displayed behavioral alterations progressing to altered consciousness, febrile peaks, and challenging epileptic status, requiring intensive care and mechanical ventilation. The diagnosis was made based on MRI and anti-N-methyl-D-aspartate (anti-NMDA) antibodies. Treatment involved intravenous (IV) immunoglobulins, plasmapheresis, and corticosteroids. After discharge, both had cognitive sequelae. Autoimmune encephalitis is a pathological condition that still lacks thorough exploration and reporting. It predominantly affects young patients without a history of acute psychiatric symptoms, necessitating consideration when behavioral alterations emerge. The challenges faced by small cities, including a shortage of technical resources, further impede the timely and precise diagnosis of this intricate condition.