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ObjectivesWe reviewed the current health service delivery for individuals with Autoimmune Encephalitis (AE) in the Philippines and to identify the gaps and challenges in its management.MethodologyWe conducted a scoping review of pertinent literature AE in the Philippines using the Preferred Reporting Items for Systematic reviews and Meta-analysis (PRISMA) guidelines. We extracted data on epidemiology, legislation, health financing, information systems, pharmacotherapy, and healthcare services related to the management of AE in the local setting.DiscussionThe epidemiology of AE is still unknown. Out-of-pocket expenses contribute to most of the healthcare expenditure despite government-led programs to reduce the financial burden. The access to diagnostic examinations such as magnetic resonance imaging, electroencephalogram, and antibody testing is limited by the geographic distribution of the facilities and costs. The acute and long-term management of AE are cost-prohibitive and are not readily available. There are significant treatment gaps in the care of individuals with AE in the Philippines in terms of disease recognition, resource allocation, access to satisfactory diagnostic evaluation, and provision of prognosis-changing therapeutics. We proposed core strategies that can address these treatment gaps such as increasing awareness, improving access to health resources, adequate healthcare financing, and availability of support systems.

Background: Wernicke-Korsakoff syndrome (WKS) is a triad of ophthalmoplegia, ataxia and memory deficits due to thiamine insufficiency resulting from under- or untreated Wernicke’s encephalopathy (WE), which may be associated with hyperemesis gravidarum (HEG). Case presentation: We present a case of a 36-year-old Filipino woman in her first trimester with HEG, along with the WKS triad and abnormal hyperintense signals in the bilateral thalami and midbrain, left occipital lobe, periaqueductal gray matter and pontine periventricular areas. Neurologic deficits partially improved but persisted despite intravenous thiamine administration. Evidence review: A review of current treatments for WE, and the prevention and neurocognitive recovery of WKS was done. The beneficial effects of thiamine for acute WKS are supported by several case reports and clinical experience. Evidence from one randomized controlled trial wherein thiamine was given in various doses for treating WE or preventing WKS in an alcohol-dependent population is limited by methodological issues. Rehabilitation and pharmacotherapy for neurocognitive recovery seems promising, but they have inadequate evidentiary support. More robust studies on multi-modal strategies are warranted to facilitate the neurocognitive recovery of patients with WKS.