Clinical decision-making in relation to autoimmunity: insights from catatonia and autoimmune encephalitis

TL;DR

This paper discusses how autoimmune conditions like autoimmune encephalitis can cause catatonia and emphasizes the importance of combining clinical findings with antibody testing for accurate diagnosis.

Contribution

The paper advocates for structured diagnostic algorithms and early immune therapy in suspected autoimmune catatonia cases, even without confirmed antibodies.

Findings

Autoimmune encephalitis is a significant cause of catatonia with autoimmune origins.

Autoantibody testing should be interpreted alongside clinical findings for accurate diagnosis.

Timely immune therapy is recommended in selected cases, even without confirmed antibody results.

Abstract

Catatonia can be associated with a diverse range of conditions, including autoimmune encephalitis. Although rare, autoimmune encephalitis accounts for a significant proportion of catatonia cases with autoimmune aetiologies. In instances where autoimmune mechanisms are suspected, autoantibody testing is a key component of the diagnostic evaluation. However, test results should always be interpreted in conjunction with clinical findings. This article highlights the diagnostic challenges involved, advocating for structured diagnostic algorithms and timely initiation of immune therapy in carefully selected cases – particularly when antibody confirmation is absent. It revisits the paper, ‘Retrospective chart review of cases with steroid-responsive catatonia: exploring a potential autoimmune etiology’.

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