FINDINGS | COMMENTS |
---|---|
Subacute clinical course | 1–3 months of symptoms |
Viral-like prodrome | Fever, malaise, headache, gastrointestinal symptoms, etc |
Neurocognitive deficits | Agitation, apathy, catatonia, delusions, irritability, mania, psychosis, and paranoia |
Neurologic examination abnormalities | Ataxia, brain stem abnormalities, myoclonus, tremor, or myelopathy |
New-onset focal seizure disorder or status epilepticus | Often not responsive to antiepileptic medications |
New focal electroencephalogram abnormalities | Focal epileptic or slow-wave activity particularly arising from the temporal lobes |
Subacute movement disorder | Dyskinesias, dystonia, or choreoathetosis |
Subacute sleep disturbance | Central sleep apnea, central neurogenic hypoventilation, or narcolepsy |
Subacute autonomic dysfunction | Hyperhidrosis, tachyarrhythmias, labile blood pressure, central hypoventilation, gastrointestinal dysmotility, urinary dysfunction |
Brain MRI abnormalities | Bilateral T2-weighted FLAIR hyperintensities in the medial aspect of the temporal lobes, although multifocal changes involving the gray and white matter are also possible |
Inflammatory cerebrospinal fluid | Mild to moderate pleocytosis (white blood cell count 5–100/μL) |
Previous or current oncologic disorder or risk factors for malignancy such as smoking | Increased risk of a paraneoplastic disorder |
FLAIR = fluid-attenuated inversion recovery; MRI = magnetic resonance imaging