International consensus definitions for infection-triggered encephalopathy syndromes.
Hiroshi Sakuma, Terrence Thomas, Carly Debinski and 15 others
PMID 39143740WHAT IT FOUND
This paper defines infection-triggered encephalopathy syndromes (ITES) as distinct from infectious or autoimmune encephalitis.
It provides consensus diagnostic criteria for five syndromes, emphasizing specific MRI patterns and the exclusion of other causes, to guide early recognition in acute care.
Key findings
01ITES are defined by a febrile illness within 7 days of neurological onset, encephalopathy, and the exclusion of infectious or autoimmune encephalitis.
02Diagnosis relies heavily on syndrome-specific MRI findings, such as bilateral thalamic lesions for ANE and splenial corpus callosum lesions for MERS.
03There is currently no evidence-based therapy for ITES, though early immune-directed treatments are being explored for severe forms.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The definitions are based on expert consensus and opinion, not generated from a new systematic review. The criteria have not yet been validated in a real-world cohort. There are cases that meet ITES criteria but do not fit any of the defined syndromes. The distinction between ITES and other encephalopathies can be difficult in hyperacute cases where full investigation is not possible.
Declared interests
Funding was provided by Japanese government health and research agencies. Individual authors declared various financial relationships with pharmaceutical companies (e.g., CSL Behring, Novartis, Roche) and charities, but no single sponsor is stated to have designed the study or written the manuscript.
The easy way to misread this
Do not use these criteria to diagnose a patient without excluding infectious and autoimmune encephalitis. The 'possible ITES' category is heterogeneous and may include undiagnosed diseases; overuse of this label is discouraged.