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©2013 UpToDate ® Print Email Diagnosis and treatment of paraneoplastic and autoimmune encephalitis GlyR: glycine receptor; IVIg: IV immunoglobulin; LGI1: leucine-rich glioma-inactivated 1. * Differential diagnosis and exclusion of other disorders has been examined in several reviews. • Unknown antigens refer to antigens whose identity has not been established but are visible using patients' antibodies with brain immunohistochemistry and cultures of neurons. Δ T-cell suppression refers to strategies focused on decreasing T-cell activation (rituximab) and cytotoxic T-cell mechanisms (cyclophosphamide, tacrolimus, or cyclosporine). ◊ Tumor surveillance and chronic immunosuppression should be considered in some disorders (α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor [AMPAR], γ-aminobutyric acid-B receptor [GABA B -R], and contactin-associated protein-like 2 [Caspr2]) and subgroups of patients with anti-NMDA receptor (NMDAR) encephalitis with higher risk for relapse (eg, patients without tumor) or to have an underlying tumor (older than 18 years). Reproduced with permission from: Lancaster E, Martinez-Hernandez E, Dalmau J. Encephalitis and antibodies to synaptic and neuronal cell surface proteins. Neurology 2011; 77:179. Copyright © 2011 Lippincott Williams & Wilkins.