Autoimmune basal ganglia encephalitis

Clinic

• BGE is characterized by the relatively rapid development of symptoms of parkinsonism such as akinesia, rigidity, and tremors.
• Autoimmune inflammation of the basal ganglia structures.
• Various autoantibodies, namely, dopamine D2 receptor (D2R), N-methyl-D-aspartate receptor (NMDAR), and anti-LGI1, trigger it.
• When it occurs as a paraneoplastic manifestation usually due to ovarian teratomas, then anti-recoverin antibodies are classically associated. In these cases, there is additional development of retinopathy, also termed cancer-associated retinopathy (CAR)
• The clinical presentation can also include other features such as
  • Cognitive abnormalities
  • Seizures

PANDAS

PANS and PANDAS are a type of basal ganglia encephalitis.

• Obsessions/compulsions
• Depression
• Mood swings

• Acute movement disorders
• Executive dysfunction
• Fine motor difficulties
• Anxiety

Causation

Reference

• Respiratory viruses (INFL, RSV, PIV , HMPV, RNV, COV-2, COV-19, ADV, HBOV)
• CJD
• Arbovirus (DHF, RVF, JE, WNE, TBE, YF)
• MTB

Entities / Miasms

	CJD	JE	WNE	TBE
Parkinsonism (Rigidity / Bradikinesia / Tremor)	3+	3+	3+	1+
Cognition impaired (executive function)	2+	3+	2+	3+
Emotional lability / Anxiety / Depression	--	1+	--	3+
Awakward, Inccordination	1+	3+	2+	3+
Seizure	2+	3+	--	2+