antibodies against neural cell On review of a continuing authorisation period surface antigens (if not already known) Clinical effectiveness of Ig therapy may be demonstrated by: OR Definite clinical improvement or stability in symptoms Patient has failed to demonstrate a (including psychiatric behaviour, cognitive dysfunction, clinically significant improvement in seizures, movement disorders) compared to the symptoms compared to the previous review severity of symptoms at qualifying AND and as measured by the Modified Rankin Score compared to No further deterioration in disability as measured by a qualifying value Modified Rankin Score that is greater than or equal to the previous review score AND AND Second line treatment with immune-suppressant agents has A trial of weaning is planned or a valid reason provided been commenced and testing as to why a trial is not being planned or is confirms the presence of antibodies contraindicated at this time. against neural cell surface antigens. Suspected AMAE - results not available or sero-negative AMAE or sero limbic encephalitis On review of a continuing authorisation period IVIg should be used for a maximum of months (induction Re-authorisation may only be plus two maintenance cycles) before determining whether the approved where there is clinical patient has responded. However if a patient has not improvement or stability in responded within the first month, the addition of second line symptoms treatment should be considered well before the end of that AND three month period. has been no further deterioration as measured by a Modified Rankin Score that is
antibodies against neural cell surface antigens (if not already known) OR Patient has failed to demonstrate a clinically significant improvement in symptoms compared to the severity of symptoms at qualifying and as measured by the Modified Rankin Score compared to qualifying value AND Second line treatment with immune-suppressant agents has been commenced and testing confirms the presence of antibodies against neural cell surface antigens. On review of a continuing authorisation period Re-authorisation may only be approved where there is clinical improvement or stability in symptoms AND has been no further deterioration as measured by a Modified Rankin Score that is On review of a continuing authorisation period Clinical effectiveness of Ig therapy may be demonstrated by: Definite clinical improvement or stability in symptoms (including psychiatric behaviour, cognitive dysfunction, seizures, movement disorders) compared to the previous review AND No further deterioration in disability as measured by a Modified Rankin Score that is greater than or equal to the previous review score AND A trial of weaning is planned or a valid reason provided as to why a trial is not being planned or is contraindicated at this time. Suspected AMAE - results not available or sero-negative AMAE or sero limbic encephalitis IVIg should be used for a maximum of months (induction plus two maintenance cycles) before determining whether the patient has responded. However if a patient has not responded within the first month, the addition of second line treatment should be considered well before the end of that three month period.
Autoimmune-encephalitis-mediated-by-antibodies-targeting-cell-surface-antigens%28AMAE%292017.docx