Autoimmune disease happens when the body’s natural defense system cannot tell the difference between your own cells and foreign cells, causing the body to mistakenly attack normal cells. Autoimmune disorders can affect any part of the body including the nervous system.
Autoimmune neurology is a rapidly evolving field and our understanding of these disorders has increased considerably in recent years. Any part of the nervous system can be affected leading to disorders such as Autoimmune Encephalitis, Myasthenia Gravis, and Guillain-Barre Syndrome. Antibodies that target the nervous system have been discovered. Some neurological disorders may be associated with a specific antibody, however others overlap, and similar symptoms can be associated with several different antibodies. Sometimes an autoimmune disorder is suspected but no known antibody is detected. Researchers continue to discover new antibodies every year.
Autoimmune neurological disorders can also occur with cancer and when this happens they are described as paraneoplastic disorders. Some patients have a known history of cancer, but in others the neurological symptoms may be the first sign of cancer. Screening for cancer and treating any underlying cancer is an important part of treating the neurological symptoms.
Autoimmune neurological disorders have also appeared in popular culture. ‘Brain on Fire’ is the story of a young journalist who suffered from anti-NMDA receptor encephalitis. This disorder typically occurs in young women and presents with psychosis, abnormal movements, seizures, and coma, and has been associated with ovarian tumours. Fortunately, if treated with immunosuppression the chances of a good recovery are high in this disorder.
Diagnosing and managing autoimmune neurological disorders is challenging. Drs Jennifer Taylor and Evan Jolliffe have a special interest in autoimmune neurological disorders and also review patients in a dedicated Neuroimmunology Clinic at Wellington Hospital.
