When your own body attacks your brain? (Autoimmune Encephalitis) Let's learn about it.

Have you ever wondered what would happen if your own body's defense system, the immune system , started working against your own brain? It sounds a little scary, doesn't it? That's the kind of condition we're going to talk about today, called Autoimmune Encephalitis (AE). Simply put, what happens when our immune system, which acts like a sentinel in our body, mistakenly attacks the healthy cells in our own brain and the things that carry messages between them. It's like our house security guard thinking we're a thief and attacking us.

So what is this autoimmune encephalitis?

Okay, let's explain a little more. Autoimmune Encephalitis (AE) is not a single disease, it's a group of diseases. In each of these, there is inflammation , or swelling, inside your brain. This is because, as mentioned earlier, your immune system mistakenly attacks certain proteins and neurotransmitters in your brain's healthy nerve cells . Think about it, our brain is like a complex computer system. These nerve cells and neurotransmitters are like wires and signals in it. So, when the immune system attacks it, the whole system goes haywire. This is why symptoms like memory loss, seizures, and psychosis occur.

What are the symptoms of this? How do we recognize it?

Because there are different types of autoimmune encephalitis, the symptoms can vary greatly. Also, these symptoms do not appear suddenly. They develop gradually over a period of weeks to months. If you or someone you know has these symptoms, it is important to seek medical advice immediately.

Here are some things you might experience:

• Feeling like your cognitive abilities are gradually decreasing. It's like your brain is slowing down a bit.
• Memory problems. It becomes difficult to remember new things, and you may even forget old things.
• Confusion. You can't figure out where you are or what you're doing.
• Seizures. These are sometimes difficult to control with standard epilepsy medications.
• Abnormal movements. For example, mouth and face movements that are repeated over and over again, muscle twitching, and startle response to even the slightest thing (`exaggerated startle response`).
• Difficulty speaking (aphasia). Difficulty forming words and expressing ideas.
• Loss of balance (ataxia) or coordination problems when walking. You may walk like a drunk person.
• Psychosis. This includes seeing, hearing, and feeling things that are not real (hallucinations). It can also include delusions and paranoia, which are false beliefs that others are trying to harm you.

Important: If you have one or more of these symptoms, it does not necessarily mean you have Autoimmune Encephalitis. However, if you have any of these symptoms, it is best to see a qualified doctor immediately and get checked out.

What other complications can this cause?

Autoimmune encephalitis can lead to complications if not treated properly, which is why it is important to recognize the disease and begin treatment as soon as possible.

• Permanent impairment of thinking ability (`Cognitive impairment`).
• Prolonged epileptic states (`status epilepticus`).
• Coma.
• Even death can occur. But this is more likely to happen if treatment is not sought or if treatment is delayed.

Why do we have this? What are the reasons?

Researchers believe that autoimmune encephalitis occurs when our immune system makes antibodies against specific proteins on the surface of our own nerve cells or inside them. These antibodies bind to those proteins and stop them from working. This causes inflammation in the brain.

Like many autoimmune conditions, it is not yet fully understood why our immune system attacks healthy cells in this way. In some cases, autoimmune encephalitis (AE) can occur with cancer. Doctors call this paraneoplastic AE. In other cases, infections such as the herpes simplex virus can also cause it. However, for most people, there is no known trigger for AE.

Who is most at risk of developing this disease?

If you have these things, you are slightly more likely to develop autoimmune encephalitis:

• If you have cancer or if you develop a new one, especially small cell lung cancer, thymoma, and ovarian cancer .
• If you have taken certain immune therapies (immune checkpoint inhibitors) for cancer .
• If you have previously had an infection of the brain (infectious encephalitis) .

However, it is important to remember that autoimmune encephalitis (AE) can develop even without any of these risk factors.

How is this disease diagnosed? What tests are needed?

Doctors diagnose autoimmune encephalitis based on symptoms that appear over a period of time and test results that show inflammation inside your brain.

Since there are many other conditions that can cause similar symptoms to this `AE` condition, you may need to undergo several tests. Sometimes it can take weeks to get a diagnosis. Don't worry, the doctors will do what's best for you.

These are some of the tests and methods used to diagnose AE:

• Physical examination and taking your complete medical history.
• A special examination related to the nervous system (`Neurological exam`).
• Cognitive tests.
• Blood tests.
• Brain imaging tests. For example, a brain MRI scan (`Brain MRI`).
• A test that involves taking cerebrospinal fluid (`Spinal tap`).
• EEG (Electroencephalogram) test. This measures the electrical activity of the brain.

Your doctor may also recommend further tests to rule out other medical conditions.

What are the treatments for this?

There are two main goals in treating autoimmune encephalitis: suppressing the immune system (immunosuppression) and removing a tumor, if present.

First-line therapy

These treatments work by reducing inflammation in the brain.

• Corticosteroids - These are powerful medications that reduce inflammation.
• IV immunoglobulins (IVIG) - These are a solution containing healthy antibodies. They are given intravenously.
• Plasmapheresis - This is a procedure where harmful antibodies are removed from your blood and the purified blood is returned to your body.

What if this treatment is not successful?

If first-line treatments don't produce the desired results, doctors may consider other treatments, such as:

• Rituximab - This is a monoclonal antibody type of vaccine.
• Cyclophosphamide - This is also used as a chemotherapy medication.

What if there is a tumor?

If you are diagnosed with a tumor, your medical team may recommend surgical removal and/or chemotherapy . This can help speed up the healing of your AE condition.

Symptom management

You may need additional medications to control the symptoms of AE:

• Antiseizure medications - reduce or prevent epileptic seizures.
• Medications to treat anxiety and depression. Examples include antidepressants and anxiolytics.
• If there is mental disorder (`psychosis`), then medications are given for that (`Antipsychotic medications`).

Additionally, physical therapy, occupational therapy, and/or speech therapy can be very helpful in speeding up your recovery.

To what extent can this disease be cured?

The success of treatment for autoimmune encephalitis (AE) varies from person to person. Some people respond well to the first few days of treatment. Others may need to take treatment for weeks or months.

It's hard for doctors to predict exactly how your body will respond to treatment. But they will monitor your condition closely and keep you informed. Trust that the doctors will help you.

What is the prognosis for someone with this disease?

In general, if autoimmune encephalitis is diagnosed and treated early, the risk of long-term complications and relapse can be reduced.

But AE is not the same for everyone. If you have other medical conditions, such as cancer, that can also affect your outlook. Your medical team can give you a good idea of ​​what to expect.

Is this a lifelong illness?

Most of the time, autoimmune encephalitis responds well to treatment and gets better. However, for some people, this can take a long time. Also, AE can come back (relapse), especially if your cancer is not responding well to treatment.

Autoimmune encephalitis is a serious condition that requires immediate medical attention. Because there are different types, symptoms can vary, and diagnosis can take some time. However, remember that your medical team will work together to diagnose the condition and start treatment as soon as possible.

Finally, things to remember

The name Autoimmune Encephalitis can be a bit scary, but being aware of it can help you take action quickly if symptoms appear.

• What happens in this is that your own immune system attacks your brain.
• Symptoms such as memory problems, confusion, epilepsy, unusual movements, difficulty speaking, and mental changes may occur.
• If you have these symptoms, definitely see a doctor.
• It is very important to diagnose the disease and start treatment early.
• There is treatment, and many people recover.
• Sometimes the disease can recur, so it is important to follow medical advice.

If you or someone you know has any further questions about this, don't be afraid to talk to a doctor. They are more than happy to help you.

` Autoimmune Encephalitis, Inflammation of the brain, Immune system, Memory loss, Epilepsy, Mental illness