Testing and Treatment De-Mystified

The number of tests used to diagnose disease can be overwhelming and it’s easy to get confused by all the acronyms.

Treatment protocols vary from patient to patient but you may be offered some combination of the following.

Alphabet Soup of Acronyms

• EKG = ECG (electrocardiogram or echocardiogram) looks at heart function

• EEG (electroencephalogram) measures electrical activity in the brain—useful for diagnosing seizure activity

• CT (computed tomography) is quicker but provides less detail than an MRI

• MRI (magnetic resonance imaging test) may be ordered with or without contrast dye to provide even more detailed structural information

• PET (positron emission tomography) scan gives more functional information compared to a CT or MRI (i.e., issues with oxygen, glucose, blood flow)

• LP (lumbar puncture) aka spinal tap

• CSF (cerebrospinal fluid) is collected during a spinal tap and sent for antibody testing

First-Line Treatments Commonly Used to treat AE

You may be treated with one, two, or three of these protocols commonly used to reduce brain inflammation:

• High-dose steroids are often given first to rapidly decrease inflammation in the brain. Usually, a patient is admitted to hospital for a few days to receive intravenous steroids and to be monitored for any adverse effects.

• IVIG (intravenous immunoglobulin) is a blood product extracted and collected from the blood plasma of donors. It is thought to decrease inflammation and strengthen the immune system by stopping harmful antibodies from attaching to receptors in the brain.

• PLEX (plasma exchange or plasmapheresis) is an outpatient procedure where a patient’s blood and plasma are separated, essentially cleaning out harmful substances and inflammatory antibodies and replacing them with donor plasma.

If these treatments do not result in improvement, second-line treatments with drugs such as rituximab or others may be suggested. There are also third-line treatments that may be considered.