| Howard and Lees criteria for encephalitis lethargica6
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| ‘An acute or subacute encephalitic illness which has as part of its clinical picture at least three of the following major criteria: (1) signs of basal ganglia involvement, (2) oculogyric crises, (3) ophthalmoplegia, (4) obsessive-compulsive behaviour, (5) akinetic mutism, (6) central respiratory irregularities, and (7) somnolence and/or sleep inversion.’ |
| DSM-5-TR criteria for catatonia45
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‘Catatonia is defined as the presence of three (or more) of the following symptoms:
1.Stupor (i.e., no psychomotor activity; not actively relating to environment). 2.Catalepsy (i.e., passive induction of a posture held against gravity). 3.Waxy flexibility (i.e., slight, even resistance to positioning by examiner). 4.Mutism (i.e., no, or very little, verbal response [exclude if known aphasia]). 5.Negativism (i.e., opposition or no response to instructions or external stimuli). 6.Posturing (i.e., spontaneous and active maintenance of a posture against gravity). 7.Mannerism (i.e., odd, circumstantial caricature of normal actions). 8.Stereotypy (i.e., repetitive, abnormally frequent, non-goal-directed movements). 9.Agitation, not influenced by external stimuli. 10.Grimacing. 11.Echolalia (i.e., mimicking another’s speech). 12.Echopraxia (i.e., mimicking another’s movements).’
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| Graus criteria for possible autoimmune encephalitis44
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| Diagnosis can be made when all three of the following criteria have been met: |
1. Subacute onset (rapid progression of <3 months) of working memory deficits (short-term memory loss), altered mental status or psychiatric symptoms -
2. At least one of the following:
• New focal CNS findings • Seizures not explained by a previously known seizure disorder • CSF pleocytosis (white blood cell count of more than five cells per mm3) • MRI features suggestive of encephalitis
3. Reasonable exclusion of alternative causes
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| Graus criteria for probable NMDA receptor encephalitis44
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| Diagnosis can be made when all three of the following criteria have been met: |
-
1. Rapid onset (<3 months) of at least four of the six following major groups of symptoms:
• Abnormal (psychiatric) behaviour or cognitive dysfunction • Speech dysfunction (pressured speech, verbal reduction, mutism) • Seizures • Movement disorder, dyskinesias or rigidity/abnormal postures • Decreased level of consciousness • Autonomic dysfunction or central hypoventilation
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2. At least one of the following laboratory study results:
• Abnormal EEG (focal or diffuse slow or disorganized activity, epileptic activity, or extreme delta brush) • CSF with pleocytosis or oligoclonal bands
3. Reasonable exclusion of other disorders (appendix)
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| Diagnosis can also be made in the presence of three of the above groups of symptoms accompanied by a systemic teratoma |
