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Dr.Sumanth, Doctor (MD)
Category: Neurology
Satisfied Customers: 14638
Experience:  Consultant Pediatrician at Kanchi Kamakoti CHILDS Trust Hospital
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My husband is recovering from auto immune encephalitis and

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Hi, my husband is recovering from auto immune encephalitis and has been pretty stable for the last 2 years or so but has had an intense headache,bouts of confusion and anger over the last week. He’s done to 4mg pred and ideally don’t want to go back up cause he’s been on it for 5 years. Is it feasible that he might be able to get a maintenance dose of rituximab.
JA: Is the headache episodic or daily? And what about nausea?
Customer: Almost constant with occasional nausea
JA: Is there anything else the Doctor should know before I connect you? Rest assured that they'll be able to help you.
Customer: Not sure really
Hi...Welcome to Just Answer. I am Dr. Sumanth Amperayani. I have 16 years of experience in the field of Medicine at a tertiary care referral hospital. I am currently reviewing your question.Kind regards ***** ***** Sumanth Amperayani
I understand your concern and I am sorry for his symptoms.
Unfortunately the answer to your question is no because the medication is useful only.
AI encephalitis generally responds well to first-line treatment, particularly corticosteroids, and outcomes are generally good, however, in the long-term cognitive problems are common.
Previously long term neuropsychiatric manifestations were thought to be very subtle in this particular disease.
But now, there is emerging evidence that subtle neurocognitive/psychosocial issues may be more prevalent than previously appreciated. Support from psychology/counselling services and charitable groups, such as the Encephalitis Society, is vital in the recovery phase.
Antipsychotic medications should be given a second thought because of the prevalence of neuroleptic malignant syndrome when used in the backdrop of autoimmune encephalitis.I sincerely ***** ***** I have helped you today!Is there anything else where I can be of assistance to you in this regard please. We can continue here until you are satisfied, simply use the reply box and let me know.Kind regards ***** ***** Sumanth Amperayani
Customer: replied 12 days ago.
My concern is that this episode is a considerable and prolonged decline from his usual state and that the auto antibodies may have significantly increased again. His neurologist is now retired and I think we’ve been signed off a couple of years. I take it you think likely that steroids will be put up again in which case?
And when you say Psychosocial would that be stress factors etc?

No please, not steroids.

I feel cognitive behavioral therapy is the best.

Customer: replied 12 days ago.
Thank you for your time, we hate the steroids and have been trying to get off them for a couple of years so that’s good to hear. Many thanks

I am happy that my interaction was helpful for you and put your mind at ease.

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Kind regards ***** ***** Sumanth Amperayani

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