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Record W4401205347 · doi:10.1055/s-0044-1788586

Brazilian consensus recommendations on the diagnosis and treatment of autoimmune encephalitis in the adult and pediatric populations

2024· article· en· W4401205347 on OpenAlexaboutno aff
Lívia Almeida Dutra, Pedro Victor de Castro Silva, João Henrique Fregadolli Ferreira, Alexandre Coelho Marques, Fabio Fieni Toso, Cláudia Cristina Ferreira Vasconcelos, Doralina Guimarães Brum, Samira Luísa Apóstolos‐Pereira, Tarso Adoni, Letícia Januzi de Almeida Rocha, Letícia Pereira de Brito Sampaio, Nise Alessandra de Carvalho Sousa, Renata Barbosa Paolilo, Angélica Dal Pizzol, Bruna Klein da Costa, Caio César Diniz Disserol, Camila Pupe, Daniel Almeida do Valle, Denise Sisterolli Diniz, Fabiano Ferreira Abrantes, Felipe da Rocha Schmidt, Fernando Cendes, Francisco Tomaz Meneses de Oliveira, Gabriela Joca Martins, Guilherme Diogo Silva, Kátia Lin, Lécio Figueira Pinto, Mara Lúcia Schimtz Ferreira Santos, Marcus Vinícius Magno Gonçalves, Mariana Braatz Krueger, Michel E. Haziot, Orlando Graziani Póvoas Barsottini, Osvaldo J. M. Nascimento, Paulo Ribeiro Nóbrega, Priscilla Mara Proveti, Raphael Machado Castilhos, Vanessa Daccach Marques, Felipe von Glehn

Bibliographic record

VenueArquivos de Neuro-Psiquiatria · 2024
Typearticle
Languageen
FieldMedicine
TopicAutoimmune Neurological Disorders and Treatments
Canadian institutionsnot available
Fundersnot available
KeywordsMedicineAcute disseminated encephalomyelitisRituximabEncephalitisAutoimmune encephalitisPlasmapheresisPediatricsAntibodyImmunologyInternal medicineMultiple sclerosisAutoantibody

Abstract

fetched live from OpenAlex

BACKGROUND: Autoimmune encephalitis (AIE) is a group of inflammatory diseases characterized by the presence of antibodies against neuronal and glial antigens, leading to subacute psychiatric symptoms, memory complaints, and movement disorders. The patients are predominantly young, and delays in treatment are associated with worse prognosis. OBJECTIVE: With the support of the Brazilian Academy of Neurology (Academia Brasileira de Neurologia, ABN) and the Brazilian Society of Child Neurology (Sociedade Brasileira de Neurologia Infantil, SBNI), a consensus on the diagnosis and treatment of AIE in Brazil was developed using the Delphi method. METHODS: A total of 25 panelists, including adult and child neurologists, participated in the study. RESULTS: The panelists agreed that patients fulfilling criteria for possible AIE should be screened for antineuronal antibodies in the serum and cerebrospinal fluid (CSF) using the tissue-based assay (TBA) and cell-based assay (CBA) techniques. Children should also be screened for anti-myelin oligodendrocyte glucoprotein antibodies (anti-MOG). Treatment should be started within the first 4 weeks of symptoms. The first-line option is methylprednisolone plus intravenous immunoglobulin (IVIG) or plasmapheresis, the second-line includes rituximab and/or cyclophosphamide, while third-line treatment options are bortezomib and tocilizumab. Most seizures in AIE are symptomatic, and antiseizure medications may be weaned after the acute stage. In anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis, the panelists have agreed that oral immunosuppressant agents should not be used. Patients should be evaluated at the acute and postacute stages using functional and cognitive scales, such as the Mini-Mental State Examination (MMSE), the Montreal Cognitive Assessment (MoCA), the Modified Rankin Scale (mRS), and the Clinical Assessment Scale in Autoimmune Encephalitis (CASE). CONCLUSION: The present study provides tangible evidence for the effective management of AIE patients within the Brazilian healthcare system.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.098
Threshold uncertainty score0.416

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.056
GPT teacher head0.322
Teacher spread0.266 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations5
Published2024
Admission routes1
Has abstractyes

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