Diagnostic and Therapeutic Approach to Autoimmune Neurologic Disorders

A. Sebastian López-Chiriboga, MD; Eoin P. Flanagan, MD


Semin Neurol. 2018;38(3):392-402. 

In This Article

Evaluation of Alternative Causes and Mimics

Excluding an infectious etiology is extremely important when first evaluating a patient for a suspected autoimmune neurologic disorder. Infection should also be considered in patients with autoimmune neurologic disorders who relapse while taking immunosuppressants, as a neurologic infection may mimic a relapse.[5] Other related autoimmune disorders such as vasculitis, lupus, sarcoidosis, Sjögren's syndrome, Bechet's disease, and lymphoproliferative disease should be considered.[6] Oncologic disorders such as gliomas, gliomatosis cerebri, CNS lymphomatosis, and metastatic disease can mimic autoimmune disorders; reduction in edema or resolution of lesions completely with corticosteroids can be mistaken for immunotherapy responsiveness and should be a consideration in those with an uncertain diagnosis that respond to steroids. The differential diagnosis also includes other general medical conditions such as nutritional deficiencies, drugs/toxins exposures, neurogenetic, metabolic and neurodegenerative disorders, as well as functional neurologic disorders.[7]