Autoimmune encephalitis in a tertiary hospital in the Philippines

Autoimmune Encephalitis in the Philippines: A Scoping Review on the Treatment Gaps, Challenges, and Current State of Care

“…In a retrospective study done in 2020 that reviewed 18 cases (12 adults and six children) of patients with AE admitted to the Philippine General Hospital (PGH), the largest tertiary hospital providing neurologic care in the Philippines, the median age of onset was 13 years among pediatric cases and 32 years in the adult with a male-female ratio of 1:2.6 (15). Anti-NMDAR antibody AE was the most common type in adults (58.3%) and children (100%) and other documented syndromes had antibodies against alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid receptor (AMPAR), voltage-gated potassium channel complex (VGKC-complex), and multiple antibodies (NMDAR + AMPAR, NMDAR + VGKC) (15). The diagnosed cases with anti-VGKC antibodies still used this nomenclature since the identification of specific antibodies to the anti-VGKC namely leucine-rich glioma-inactivated (LGI1) and contactinassociated protein-like 2 (CASPR2) were not yet implemented.…”

“…The diagnosed cases with anti-VGKC antibodies still used this nomenclature since the identification of specific antibodies to the anti-VGKC namely leucine-rich glioma-inactivated (LGI1) and contactinassociated protein-like 2 (CASPR2) were not yet implemented. EEG was done in 17 of the patients where 16 had abnormalities with five adults presenting with status epilepticus (SE) (15). In terms of antiseizure treatment, 14 needed polytherapy and only three were on monotherapy (15).…”

“…EEG was done in 17 of the patients where 16 had abnormalities with five adults presenting with status epilepticus (SE) (15). In terms of antiseizure treatment, 14 needed polytherapy and only three were on monotherapy (15). In terms of immunotherapy, 17 received first-line immunotherapy, nine had MMPT and IVIG, six had MPPT only, one had high dose MPPT and PLEX, and one had IVIG alone.…”

“…In terms of immunotherapy, 17 received first-line immunotherapy, nine had MMPT and IVIG, six had MPPT only, one had high dose MPPT and PLEX, and one had IVIG alone. For the second line immunotherapy, two had cyclophosphamide, one had rituximab, and one had rituximab and cyclophosphamide (15). There is still a deficiency in the updated and local epidemiological data on AE in the Philippines as there is still no existing national registry program for AE (16).…”