Diagnostic criteria for possible autoimmune encephalitis

All three of the following criteria must be met:

Subacute onset (rapid progression of <3 months) of working memory deficits (short-term memory loss), altered mental status*, or psychiatric symptoms
At least one of the following:
- New focal CNS findings
- Seizures not explained by a previously known seizure disorder
- CSF pleocytosis (>5 white blood cells per mm³)
- MRI features suggestive of encephalitis^¶
Reasonable exclusion of alternative causes

CNS: central nervous system; CSF: cerebrospinal fluid; MRI: magnetic resonance imaging.
* Altered mental status defined as decreased or altered level of consciousness, lethargy, or personality change.
¶ Brain MRI hyperintense signal on T2-weighted fluid-attenuated inversion recovery (FLAIR) sequences highly restricted to one or both medial temporal lobes (limbic encephalitis), or in multifocal areas involving grey matter, white matter, or both, compatible with demyelination or inflammation.

Reproduced from: Graus F, Titulaer MJ, Balu R, et al. A clinical approach to diagnosis of autoimmune encephalitis. Lancet Neurol 2016; 15:391. Table used with the permission of Elsevier Inc. All rights reserved.

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Diagnostic criteria for possible autoimmune encephalitis