Analysis Of Prognostic Factors In Autoimmune Encephalitis

Objective:To analyze the features of clinical symptoms,neurological functional recovery,and the prognostic factors of autoimmune encephalitis.Methods:A retrospective study of 49 patients diagnosed with autoimmune encephalitis in the First Affiliated Hospital of Chongqing Medical University from January 2013 to May 2017 was performed.Clinical data were collected and followed up.The neurological functional recovery was evaluated through modified Ranking Scale(mRS),and the prognostic factors were analyzed using statistical methods of ordered multi-classified logistic regression analysis.Results:Among the 49 patients with autoimmune encephalitis,79.59%(39/49)were completely recovered or remained mild neurological dysfunction(mRS score<3).The prognosis of main clinical symptoms was as follows:75.61%(31/41)of the mental and behavior disorders were fully recovered,94.29%(33/35)of the seizures were controlled,69.57%(16/23)of the recent memory disorders were completely recovered,87.50%(21/24)of the inadvertent movement were controlled,90.63%(29/32)of the central nervous system focal damage were fully recovered and 16.33%(8/49)of the patients relapsed.Comparison of clinical data of initial onset among complete recovery patients group(mRS score=0 or 1),partial recovery patients group(mRS score=2 or 3)and poor prognosis patients group(mRS scored>3)showed that people in abnormal immune status before the onset(P=0.014,OR= 6.502,95%CI 1.468?28.802)and initial clinical manifestation with autonomic dysfunction or central hypoventilation(P=0.008,ORF=7.578,95%CI 1.681?34.155)had statistically significant difference.The mRS score decreased 3 points evenly after immunotherapy compared with those who were untreated(P<0.001),the difference was statistically significant.Conclusions:The majority of autoimmune encephalitis patients have favorable prognosis,but some of the patients may remain various degrees of neurological deficiency,including mental and behavior disorders,and recent memory disorders.People in abnormal immunity before the onset and initial clinical manifestation with autonomic dysfunction or central hypoventilation may indicate a poorer prognosis.Immunotherapy can improve outcomes.