Objective: To study the spectrum of movement disorders and the response to immunotherapy in patients of autoimmune encephalitis of non-neoplastic aetiology.

Background: Antibody mediated non paraneoplastic autoimmune encephalitis (AE) has emerged as one of the important differential for patients presenting with encephalopathy. Movement disorders are one of the important clinical manifestation of this disease.

Methods: We prospectively screened 362 patients of age > 12 years with encephalitis of unknown aetiology for a panel of antibodies for AE.Of the 362 patients, 41(11.3%) were seropositive for antibodies associated AE. Clinical characteristics with focus on the movement disorders were recorded. We categorized patients into 3 age groups and studied the differences in the type of movement disorder.We also studies the spectrum of movement disorder based on type of antibody.Patients were treated with immune modulating drugs and were followed up after 6 months to evaluate their functional outcome

Results: Out of the 41 patients, 21(51.2%) patients presented with movement disorder as a part of their initial clinical presentation. The commonest movement disorder encountered in our cohort was orofaciolingual dyskinesia (OFLD) 57.1%, followed by dystonia( 38.1% ), tremor (38.1%) , choreoathetosis (33.3 %) , stereotypies (14.3%), bradykinesia (14.3%), catatonia (9.5%) , neuromyotonia (4.7%) ballismus (4.7% ), ataxia (4.7%) and stiff person phenotype (4.7%.).The hyperkinetic movement disorders were more commonly seen compared to hypokinetic disorders. We found hypokinetic disorder was more commonly seen in the age > 45 years compared to the other two groups. Of 21 patients 13(61/9%) had antibodies to NMDAR,5 (23.8%) antibodies to leucine rich glioma inactivated 1 protein, 2 (9.5%) antibodies to Glutamic Acid Decarboxylase and 1(4.8%)antibodies to contactin-associated protein-like 2. All patients received immunotherapy.and 17(80.1%) had good response to immunotherapy with total remission of the movement disorder. Four patients did not have total remission but decrease in severity.

Conclusions: Our study shows that hyperkinetic movements were more prevalent in patients of autoimmune encephalitis compared to hypokinetic disorder. Timely institution of immunotherapy leads to good functional outcome in majority of patients. Presented as poster in Annual conference of Movement Disorders Society of India,India on 20.1.18.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/spectrum-of-movement-disorders-in-patients-of-autoimmune-encephalitis-of-non-neoplastic-aetiology/