Early-Stage Contactin-Associated Protein-like 2 Limbic Encephalitis: Clues for Diagnosis.

Male Humans Middle Aged Female Limbic Encephalitis Retrospective Studies Sleep Initiation and Maintenance Disorders / complications Asthenia Quality of Life Nerve Tissue Proteins Membrane Proteins Autoantibodies Encephalitis Seizures Neuralgia Contactins

Journal

Neurology(R) neuroimmunology & neuroinflammation
ISSN: 2332-7812
Titre abrégé: Neurol Neuroimmunol Neuroinflamm
Pays: United States
ID NLM: 101636388

Informations de publication

Date de publication:
01 2023
Historique:
received: 03 02 2022
accepted: 19 08 2022
entrez: 26 10 2022
pubmed: 27 10 2022
medline: 29 10 2022
Statut: epublish

Résumé

Previous studies suggested that autoimmune limbic encephalitis with antibodies against contactin-associated protein-like 2 (CASPR2-encephalitis) is clinically heterogeneous and progresses slowly, preventing its early recognition. We aimed to describe the onset and progression of CASPR2-encephalitis and to assess long-term outcomes. We retrospectively analyzed the medical records of all patients whose CSF tested positive for anti-CASPR2 antibodies in our center between 2006 and 2020. Standardized telephone interviews of all available patients and relatives were conducted, assessing long-term functional independence using the Functional Activity Questionnaire (FAQ) and quality of life using the 36-Item Short-Form Survey (SF36). Forty-eight patients were included (98% males; median age 64 years), and 35 participated in telephone interviews (73%). At onset, 81% had at least 1 neurologic symptom among the following: limbic (54%), peripheral nerve hyperexcitability (PNH; 21%), and/or cerebellar symptoms (17%). Most of the patients (75%) had initially symptoms of only one of these categories. Limbic symptoms at onset included mostly seizures (33%), while memory disturbances were less frequent (10%). PNH signs were mostly neuropathic pain (9/10 patients). Other symptoms seen at onset included asthenia (33%), mood disorders (25%), and insomnia (21%); 19% of patients did not show any limbic, peripheral, or cerebellar symptom at onset but only asthenia (15%), mood disorders (6%), weight loss (8%), dysautonomia (4%), and/or insomnia (2%). The peak of the disease was attained in median 16.7 months after onset. Over the study period (median follow-up, 58.8 months, range 10.6-189.1), 77% of patients developed ≥3 core CASPR2 symptoms and 42% fulfilled the diagnostic criteria for autoimmune limbic encephalitis, although all patients ultimately developed limbic symptoms. At the last visit, most interviewed patients (28/35 patients, 80%; median, 5 years after onset) had recovered functional independence (FAQ <9) while only the vitality subscore of the SF36 was lower than normative data (mean 49.9 vs 58.0, CASPR2-encephalitis has a progressive course and is highly heterogeneous at the early stage. In men older than 50 years, otherwise unexplained seizures, cerebellar ataxia, and/or neuropathic pain are suggestive of early-stage CASPR2-encephalitis, especially if they coincide with recent asthenia, mood disorders, or insomnia.

Sections du résumé

BACKGROUND AND OBJECTIVES
Previous studies suggested that autoimmune limbic encephalitis with antibodies against contactin-associated protein-like 2 (CASPR2-encephalitis) is clinically heterogeneous and progresses slowly, preventing its early recognition. We aimed to describe the onset and progression of CASPR2-encephalitis and to assess long-term outcomes.
METHODS
We retrospectively analyzed the medical records of all patients whose CSF tested positive for anti-CASPR2 antibodies in our center between 2006 and 2020. Standardized telephone interviews of all available patients and relatives were conducted, assessing long-term functional independence using the Functional Activity Questionnaire (FAQ) and quality of life using the 36-Item Short-Form Survey (SF36).
RESULTS
Forty-eight patients were included (98% males; median age 64 years), and 35 participated in telephone interviews (73%). At onset, 81% had at least 1 neurologic symptom among the following: limbic (54%), peripheral nerve hyperexcitability (PNH; 21%), and/or cerebellar symptoms (17%). Most of the patients (75%) had initially symptoms of only one of these categories. Limbic symptoms at onset included mostly seizures (33%), while memory disturbances were less frequent (10%). PNH signs were mostly neuropathic pain (9/10 patients). Other symptoms seen at onset included asthenia (33%), mood disorders (25%), and insomnia (21%); 19% of patients did not show any limbic, peripheral, or cerebellar symptom at onset but only asthenia (15%), mood disorders (6%), weight loss (8%), dysautonomia (4%), and/or insomnia (2%). The peak of the disease was attained in median 16.7 months after onset. Over the study period (median follow-up, 58.8 months, range 10.6-189.1), 77% of patients developed ≥3 core CASPR2 symptoms and 42% fulfilled the diagnostic criteria for autoimmune limbic encephalitis, although all patients ultimately developed limbic symptoms. At the last visit, most interviewed patients (28/35 patients, 80%; median, 5 years after onset) had recovered functional independence (FAQ <9) while only the vitality subscore of the SF36 was lower than normative data (mean 49.9 vs 58.0,
DISCUSSION
CASPR2-encephalitis has a progressive course and is highly heterogeneous at the early stage. In men older than 50 years, otherwise unexplained seizures, cerebellar ataxia, and/or neuropathic pain are suggestive of early-stage CASPR2-encephalitis, especially if they coincide with recent asthenia, mood disorders, or insomnia.

Identifiants

DOI: 10.1212/NXI.0000000000200041 PMID: 36288995 PMC: PMC9608385
pubmed: 36288995
pii: 10/1/e200041
doi: 10.1212/NXI.0000000000200041
pmc: PMC9608385
pii:
doi:

Substances chimiques

Nerve Tissue Proteins 0
Membrane Proteins 0
Autoantibodies 0
Contactins 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.

Références

Lancet Neurol. 2013 Feb;12(2):157-65
pubmed: 23290630
J Neurol Sci. 2013 Apr 15;327(1-2):73-4
pubmed: 23465509
Neurology. 2016 Oct 4;87(14):1449-1456
pubmed: 27590293
Neurology. 2016 Aug 2;87(5):521-8
pubmed: 27371488
Epilepsia. 2019 Aug;60(8):1508-1525
pubmed: 31283859
JAMA Neurol. 2016 Sep 1;73(9):1115-24
pubmed: 27428927
Neurol Neuroimmunol Neuroinflamm. 2021 May 18;8(4):
pubmed: 34006622
Brain. 2010 Sep;133(9):2734-48
pubmed: 20663977
Neurol Neuroimmunol Neuroinflamm. 2019 Dec 17;7(2):
pubmed: 31848230
Curr Opin Neurol. 2017 Jun;30(3):345-353
pubmed: 28234800
Neurol Neuroimmunol Neuroinflamm. 2021 Mar 5;8(3):
pubmed: 33848259
J Gerontol. 1982 May;37(3):323-9
pubmed: 7069156
Neurology. 2020 Jun 2;94(22):e2290-e2301
pubmed: 32424051
Ann Neurol. 2021 Oct;90(4):683-690
pubmed: 34370313
J Neurol. 2019 Jan;266(1):195-206
pubmed: 30460450
Brain. 2018 Aug 1;141(8):2263-2271
pubmed: 29788256
J Thorac Oncol. 2010 Oct;5(10 Suppl 4):S277-80
pubmed: 20859119
Ann Neurol. 2011 Feb;69(2):303-11
pubmed: 21387375
Neurol Neuroimmunol Neuroinflamm. 2020 Aug 26;7(6):
pubmed: 32847939
Clin Trials. 2020 Dec;17(6):637-643
pubmed: 32755236
J Neurol. 2020 Apr;267(4):1137-1146
pubmed: 31912210
BMC Neurol. 2014 Nov 30;14:227
pubmed: 25434587
Can J Neurol Sci. 2021 Nov;48(6):859-863
pubmed: 33557967
J Clin Invest. 2019 Mar 1;129(3):926-940
pubmed: 30714986
Lancet Neurol. 2016 Apr;15(4):391-404
pubmed: 26906964
Neurology. 2013 Oct 22;81(17):1500-6
pubmed: 24068784
Epilepsia. 2022 Mar;63(3):709-722
pubmed: 35032032
Neurology. 2015 Jun 16;84(24):2403-12
pubmed: 25979696
Front Immunol. 2021 Dec 17;12:796965
pubmed: 34975905
Ann Neurol. 2012 Aug;72(2):241-55
pubmed: 22473710
Eur J Neurol. 2017 Jan;24(1):175-186
pubmed: 27786401
J Neurol Neurosurg Psychiatry. 2020 Oct;91(10):1076-1084
pubmed: 32651251
J Geriatr Psychiatry Neurol. 2004 Jun;17(2):81-7
pubmed: 15157348

Auteurs

Jeanne Benoit (J)

From the French Reference Center on Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis (J.B., S.M.-C., A.V., A.F., A.-L.P., G.P., V.R., J.H., B.J.), Hospices Civils de Lyon; Synaptopathies and Autoantibodies (SynatAc) Team (J.B., S.M.-C., A.V., A.F., A.-L.P., G.P., V.R., J.H., B.J.), Institut NeuroMyoGène, MELIS, INSERM U1314/CNRS UMR 5284, Université Claude Bernard Lyon 1; Epileptology-EEG Department (J.B.), Neurology, Pasteur2 Hospital, University Hospitals of Nice; Côte d'Azur University (J.B.), UR2CA, URRIS, Pasteur2 Hospital, University Hospitals of Nice; Department of Functional Neurology and Epileptology (D.G., S.R.), Hospices Civils de Lyon, France; European Network for Rare and Complex Epilepsies (EPICARE) (D.G., S.R.); Service de Neurologie 2-Mazarin (A.A., D.P.), Hôpitaux Universitaires La Pitié-Salpêtrière-Charles Foix, APHP; Inserm U1127 CNRS UMR 7225 (A.A., D.P.), Institut Du Cerveau et de la Moelle épinière, ICM, Université Pierre-et-Marie-Curie, Sorbonne Universités, Paris; and Lyon's Neuroscience Research Center (S.R.), INSERM U1028/CNRS UMR 5292; Université Lyon 1 Claude Bernard, France.

Sergio Muñiz-Castrillo (S)

From the French Reference Center on Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis (J.B., S.M.-C., A.V., A.F., A.-L.P., G.P., V.R., J.H., B.J.), Hospices Civils de Lyon; Synaptopathies and Autoantibodies (SynatAc) Team (J.B., S.M.-C., A.V., A.F., A.-L.P., G.P., V.R., J.H., B.J.), Institut NeuroMyoGène, MELIS, INSERM U1314/CNRS UMR 5284, Université Claude Bernard Lyon 1; Epileptology-EEG Department (J.B.), Neurology, Pasteur2 Hospital, University Hospitals of Nice; Côte d'Azur University (J.B.), UR2CA, URRIS, Pasteur2 Hospital, University Hospitals of Nice; Department of Functional Neurology and Epileptology (D.G., S.R.), Hospices Civils de Lyon, France; European Network for Rare and Complex Epilepsies (EPICARE) (D.G., S.R.); Service de Neurologie 2-Mazarin (A.A., D.P.), Hôpitaux Universitaires La Pitié-Salpêtrière-Charles Foix, APHP; Inserm U1127 CNRS UMR 7225 (A.A., D.P.), Institut Du Cerveau et de la Moelle épinière, ICM, Université Pierre-et-Marie-Curie, Sorbonne Universités, Paris; and Lyon's Neuroscience Research Center (S.R.), INSERM U1028/CNRS UMR 5292; Université Lyon 1 Claude Bernard, France.

Alberto Vogrig (A)

From the French Reference Center on Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis (J.B., S.M.-C., A.V., A.F., A.-L.P., G.P., V.R., J.H., B.J.), Hospices Civils de Lyon; Synaptopathies and Autoantibodies (SynatAc) Team (J.B., S.M.-C., A.V., A.F., A.-L.P., G.P., V.R., J.H., B.J.), Institut NeuroMyoGène, MELIS, INSERM U1314/CNRS UMR 5284, Université Claude Bernard Lyon 1; Epileptology-EEG Department (J.B.), Neurology, Pasteur2 Hospital, University Hospitals of Nice; Côte d'Azur University (J.B.), UR2CA, URRIS, Pasteur2 Hospital, University Hospitals of Nice; Department of Functional Neurology and Epileptology (D.G., S.R.), Hospices Civils de Lyon, France; European Network for Rare and Complex Epilepsies (EPICARE) (D.G., S.R.); Service de Neurologie 2-Mazarin (A.A., D.P.), Hôpitaux Universitaires La Pitié-Salpêtrière-Charles Foix, APHP; Inserm U1127 CNRS UMR 7225 (A.A., D.P.), Institut Du Cerveau et de la Moelle épinière, ICM, Université Pierre-et-Marie-Curie, Sorbonne Universités, Paris; and Lyon's Neuroscience Research Center (S.R.), INSERM U1028/CNRS UMR 5292; Université Lyon 1 Claude Bernard, France.

Antonio Farina (A)

From the French Reference Center on Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis (J.B., S.M.-C., A.V., A.F., A.-L.P., G.P., V.R., J.H., B.J.), Hospices Civils de Lyon; Synaptopathies and Autoantibodies (SynatAc) Team (J.B., S.M.-C., A.V., A.F., A.-L.P., G.P., V.R., J.H., B.J.), Institut NeuroMyoGène, MELIS, INSERM U1314/CNRS UMR 5284, Université Claude Bernard Lyon 1; Epileptology-EEG Department (J.B.), Neurology, Pasteur2 Hospital, University Hospitals of Nice; Côte d'Azur University (J.B.), UR2CA, URRIS, Pasteur2 Hospital, University Hospitals of Nice; Department of Functional Neurology and Epileptology (D.G., S.R.), Hospices Civils de Lyon, France; European Network for Rare and Complex Epilepsies (EPICARE) (D.G., S.R.); Service de Neurologie 2-Mazarin (A.A., D.P.), Hôpitaux Universitaires La Pitié-Salpêtrière-Charles Foix, APHP; Inserm U1127 CNRS UMR 7225 (A.A., D.P.), Institut Du Cerveau et de la Moelle épinière, ICM, Université Pierre-et-Marie-Curie, Sorbonne Universités, Paris; and Lyon's Neuroscience Research Center (S.R.), INSERM U1028/CNRS UMR 5292; Université Lyon 1 Claude Bernard, France.

Anne-Laurie Pinto (AL)

From the French Reference Center on Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis (J.B., S.M.-C., A.V., A.F., A.-L.P., G.P., V.R., J.H., B.J.), Hospices Civils de Lyon; Synaptopathies and Autoantibodies (SynatAc) Team (J.B., S.M.-C., A.V., A.F., A.-L.P., G.P., V.R., J.H., B.J.), Institut NeuroMyoGène, MELIS, INSERM U1314/CNRS UMR 5284, Université Claude Bernard Lyon 1; Epileptology-EEG Department (J.B.), Neurology, Pasteur2 Hospital, University Hospitals of Nice; Côte d'Azur University (J.B.), UR2CA, URRIS, Pasteur2 Hospital, University Hospitals of Nice; Department of Functional Neurology and Epileptology (D.G., S.R.), Hospices Civils de Lyon, France; European Network for Rare and Complex Epilepsies (EPICARE) (D.G., S.R.); Service de Neurologie 2-Mazarin (A.A., D.P.), Hôpitaux Universitaires La Pitié-Salpêtrière-Charles Foix, APHP; Inserm U1127 CNRS UMR 7225 (A.A., D.P.), Institut Du Cerveau et de la Moelle épinière, ICM, Université Pierre-et-Marie-Curie, Sorbonne Universités, Paris; and Lyon's Neuroscience Research Center (S.R.), INSERM U1028/CNRS UMR 5292; Université Lyon 1 Claude Bernard, France.

Geraldine Picard (G)

From the French Reference Center on Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis (J.B., S.M.-C., A.V., A.F., A.-L.P., G.P., V.R., J.H., B.J.), Hospices Civils de Lyon; Synaptopathies and Autoantibodies (SynatAc) Team (J.B., S.M.-C., A.V., A.F., A.-L.P., G.P., V.R., J.H., B.J.), Institut NeuroMyoGène, MELIS, INSERM U1314/CNRS UMR 5284, Université Claude Bernard Lyon 1; Epileptology-EEG Department (J.B.), Neurology, Pasteur2 Hospital, University Hospitals of Nice; Côte d'Azur University (J.B.), UR2CA, URRIS, Pasteur2 Hospital, University Hospitals of Nice; Department of Functional Neurology and Epileptology (D.G., S.R.), Hospices Civils de Lyon, France; European Network for Rare and Complex Epilepsies (EPICARE) (D.G., S.R.); Service de Neurologie 2-Mazarin (A.A., D.P.), Hôpitaux Universitaires La Pitié-Salpêtrière-Charles Foix, APHP; Inserm U1127 CNRS UMR 7225 (A.A., D.P.), Institut Du Cerveau et de la Moelle épinière, ICM, Université Pierre-et-Marie-Curie, Sorbonne Universités, Paris; and Lyon's Neuroscience Research Center (S.R.), INSERM U1028/CNRS UMR 5292; Université Lyon 1 Claude Bernard, France.

Veronique Rogemond (V)

From the French Reference Center on Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis (J.B., S.M.-C., A.V., A.F., A.-L.P., G.P., V.R., J.H., B.J.), Hospices Civils de Lyon; Synaptopathies and Autoantibodies (SynatAc) Team (J.B., S.M.-C., A.V., A.F., A.-L.P., G.P., V.R., J.H., B.J.), Institut NeuroMyoGène, MELIS, INSERM U1314/CNRS UMR 5284, Université Claude Bernard Lyon 1; Epileptology-EEG Department (J.B.), Neurology, Pasteur2 Hospital, University Hospitals of Nice; Côte d'Azur University (J.B.), UR2CA, URRIS, Pasteur2 Hospital, University Hospitals of Nice; Department of Functional Neurology and Epileptology (D.G., S.R.), Hospices Civils de Lyon, France; European Network for Rare and Complex Epilepsies (EPICARE) (D.G., S.R.); Service de Neurologie 2-Mazarin (A.A., D.P.), Hôpitaux Universitaires La Pitié-Salpêtrière-Charles Foix, APHP; Inserm U1127 CNRS UMR 7225 (A.A., D.P.), Institut Du Cerveau et de la Moelle épinière, ICM, Université Pierre-et-Marie-Curie, Sorbonne Universités, Paris; and Lyon's Neuroscience Research Center (S.R.), INSERM U1028/CNRS UMR 5292; Université Lyon 1 Claude Bernard, France.

Deborah Guery (D)

From the French Reference Center on Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis (J.B., S.M.-C., A.V., A.F., A.-L.P., G.P., V.R., J.H., B.J.), Hospices Civils de Lyon; Synaptopathies and Autoantibodies (SynatAc) Team (J.B., S.M.-C., A.V., A.F., A.-L.P., G.P., V.R., J.H., B.J.), Institut NeuroMyoGène, MELIS, INSERM U1314/CNRS UMR 5284, Université Claude Bernard Lyon 1; Epileptology-EEG Department (J.B.), Neurology, Pasteur2 Hospital, University Hospitals of Nice; Côte d'Azur University (J.B.), UR2CA, URRIS, Pasteur2 Hospital, University Hospitals of Nice; Department of Functional Neurology and Epileptology (D.G., S.R.), Hospices Civils de Lyon, France; European Network for Rare and Complex Epilepsies (EPICARE) (D.G., S.R.); Service de Neurologie 2-Mazarin (A.A., D.P.), Hôpitaux Universitaires La Pitié-Salpêtrière-Charles Foix, APHP; Inserm U1127 CNRS UMR 7225 (A.A., D.P.), Institut Du Cerveau et de la Moelle épinière, ICM, Université Pierre-et-Marie-Curie, Sorbonne Universités, Paris; and Lyon's Neuroscience Research Center (S.R.), INSERM U1028/CNRS UMR 5292; Université Lyon 1 Claude Bernard, France.

Agusti Alentorn (A)

From the French Reference Center on Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis (J.B., S.M.-C., A.V., A.F., A.-L.P., G.P., V.R., J.H., B.J.), Hospices Civils de Lyon; Synaptopathies and Autoantibodies (SynatAc) Team (J.B., S.M.-C., A.V., A.F., A.-L.P., G.P., V.R., J.H., B.J.), Institut NeuroMyoGène, MELIS, INSERM U1314/CNRS UMR 5284, Université Claude Bernard Lyon 1; Epileptology-EEG Department (J.B.), Neurology, Pasteur2 Hospital, University Hospitals of Nice; Côte d'Azur University (J.B.), UR2CA, URRIS, Pasteur2 Hospital, University Hospitals of Nice; Department of Functional Neurology and Epileptology (D.G., S.R.), Hospices Civils de Lyon, France; European Network for Rare and Complex Epilepsies (EPICARE) (D.G., S.R.); Service de Neurologie 2-Mazarin (A.A., D.P.), Hôpitaux Universitaires La Pitié-Salpêtrière-Charles Foix, APHP; Inserm U1127 CNRS UMR 7225 (A.A., D.P.), Institut Du Cerveau et de la Moelle épinière, ICM, Université Pierre-et-Marie-Curie, Sorbonne Universités, Paris; and Lyon's Neuroscience Research Center (S.R.), INSERM U1028/CNRS UMR 5292; Université Lyon 1 Claude Bernard, France.

Dimitri Psimaras (D)

From the French Reference Center on Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis (J.B., S.M.-C., A.V., A.F., A.-L.P., G.P., V.R., J.H., B.J.), Hospices Civils de Lyon; Synaptopathies and Autoantibodies (SynatAc) Team (J.B., S.M.-C., A.V., A.F., A.-L.P., G.P., V.R., J.H., B.J.), Institut NeuroMyoGène, MELIS, INSERM U1314/CNRS UMR 5284, Université Claude Bernard Lyon 1; Epileptology-EEG Department (J.B.), Neurology, Pasteur2 Hospital, University Hospitals of Nice; Côte d'Azur University (J.B.), UR2CA, URRIS, Pasteur2 Hospital, University Hospitals of Nice; Department of Functional Neurology and Epileptology (D.G., S.R.), Hospices Civils de Lyon, France; European Network for Rare and Complex Epilepsies (EPICARE) (D.G., S.R.); Service de Neurologie 2-Mazarin (A.A., D.P.), Hôpitaux Universitaires La Pitié-Salpêtrière-Charles Foix, APHP; Inserm U1127 CNRS UMR 7225 (A.A., D.P.), Institut Du Cerveau et de la Moelle épinière, ICM, Université Pierre-et-Marie-Curie, Sorbonne Universités, Paris; and Lyon's Neuroscience Research Center (S.R.), INSERM U1028/CNRS UMR 5292; Université Lyon 1 Claude Bernard, France.

Sylvain Rheims (S)

From the French Reference Center on Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis (J.B., S.M.-C., A.V., A.F., A.-L.P., G.P., V.R., J.H., B.J.), Hospices Civils de Lyon; Synaptopathies and Autoantibodies (SynatAc) Team (J.B., S.M.-C., A.V., A.F., A.-L.P., G.P., V.R., J.H., B.J.), Institut NeuroMyoGène, MELIS, INSERM U1314/CNRS UMR 5284, Université Claude Bernard Lyon 1; Epileptology-EEG Department (J.B.), Neurology, Pasteur2 Hospital, University Hospitals of Nice; Côte d'Azur University (J.B.), UR2CA, URRIS, Pasteur2 Hospital, University Hospitals of Nice; Department of Functional Neurology and Epileptology (D.G., S.R.), Hospices Civils de Lyon, France; European Network for Rare and Complex Epilepsies (EPICARE) (D.G., S.R.); Service de Neurologie 2-Mazarin (A.A., D.P.), Hôpitaux Universitaires La Pitié-Salpêtrière-Charles Foix, APHP; Inserm U1127 CNRS UMR 7225 (A.A., D.P.), Institut Du Cerveau et de la Moelle épinière, ICM, Université Pierre-et-Marie-Curie, Sorbonne Universités, Paris; and Lyon's Neuroscience Research Center (S.R.), INSERM U1028/CNRS UMR 5292; Université Lyon 1 Claude Bernard, France.

Jérôme Honnorat (J)

From the French Reference Center on Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis (J.B., S.M.-C., A.V., A.F., A.-L.P., G.P., V.R., J.H., B.J.), Hospices Civils de Lyon; Synaptopathies and Autoantibodies (SynatAc) Team (J.B., S.M.-C., A.V., A.F., A.-L.P., G.P., V.R., J.H., B.J.), Institut NeuroMyoGène, MELIS, INSERM U1314/CNRS UMR 5284, Université Claude Bernard Lyon 1; Epileptology-EEG Department (J.B.), Neurology, Pasteur2 Hospital, University Hospitals of Nice; Côte d'Azur University (J.B.), UR2CA, URRIS, Pasteur2 Hospital, University Hospitals of Nice; Department of Functional Neurology and Epileptology (D.G., S.R.), Hospices Civils de Lyon, France; European Network for Rare and Complex Epilepsies (EPICARE) (D.G., S.R.); Service de Neurologie 2-Mazarin (A.A., D.P.), Hôpitaux Universitaires La Pitié-Salpêtrière-Charles Foix, APHP; Inserm U1127 CNRS UMR 7225 (A.A., D.P.), Institut Du Cerveau et de la Moelle épinière, ICM, Université Pierre-et-Marie-Curie, Sorbonne Universités, Paris; and Lyon's Neuroscience Research Center (S.R.), INSERM U1028/CNRS UMR 5292; Université Lyon 1 Claude Bernard, France.

Bastien Joubert (B)

From the French Reference Center on Paraneoplastic Neurological Syndromes and Autoimmune Encephalitis (J.B., S.M.-C., A.V., A.F., A.-L.P., G.P., V.R., J.H., B.J.), Hospices Civils de Lyon; Synaptopathies and Autoantibodies (SynatAc) Team (J.B., S.M.-C., A.V., A.F., A.-L.P., G.P., V.R., J.H., B.J.), Institut NeuroMyoGène, MELIS, INSERM U1314/CNRS UMR 5284, Université Claude Bernard Lyon 1; Epileptology-EEG Department (J.B.), Neurology, Pasteur2 Hospital, University Hospitals of Nice; Côte d'Azur University (J.B.), UR2CA, URRIS, Pasteur2 Hospital, University Hospitals of Nice; Department of Functional Neurology and Epileptology (D.G., S.R.), Hospices Civils de Lyon, France; European Network for Rare and Complex Epilepsies (EPICARE) (D.G., S.R.); Service de Neurologie 2-Mazarin (A.A., D.P.), Hôpitaux Universitaires La Pitié-Salpêtrière-Charles Foix, APHP; Inserm U1127 CNRS UMR 7225 (A.A., D.P.), Institut Du Cerveau et de la Moelle épinière, ICM, Université Pierre-et-Marie-Curie, Sorbonne Universités, Paris; and Lyon's Neuroscience Research Center (S.R.), INSERM U1028/CNRS UMR 5292; Université Lyon 1 Claude Bernard, France. bastien.joubert@chu-lyon.fr.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female

Evaluation of Low-Value Services Across Major Medicare Advantage Insurers and Traditional Medicare.

Ciara Duggan, Adam L Beckman, Ishani Ganguli et al.
1.00
Humans United States Aged Cross-Sectional Studies Medicare Part C

Effectiveness of Virtual Yoga for Chronic Low Back Pain: A Randomized Clinical Trial.

Hallie Tankha, Devyn Gaskins, Amanda Shallcross et al.
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Early-Stage Contactin-Associated Protein-like...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Adulte d'âge moyen › Early-Stage Contactin-Associated Protein-like...
questionsmedicales.fr › Maladies du système nerveux › Encéphalite › Encéphalite limbique › Early-Stage Contactin-Associated Protein-like...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Early-Stage Contactin-Associated Protein-like...
questionsmedicales.fr › Troubles mentaux › Troubles de la veille et du sommeil › Dyssomnies › Troubles du sommeil d'origine intrinsèque › Troubles de l'endormissement et du maintien du sommeil › Early-Stage Contactin-Associated Protein-like...
questionsmedicales.fr › États, signes et symptômes pathologiques › Signes et symptômes › Asthénie › Early-Stage Contactin-Associated Protein-like...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Mesures épidémiologiques › Démographie › État de santé › Qualité de vie › Early-Stage Contactin-Associated Protein-like...
questionsmedicales.fr › Acides aminés, peptides et protéines › Protéines › Protéines de tissu nerveux › Early-Stage Contactin-Associated Protein-like...
questionsmedicales.fr › Acides aminés, peptides et protéines › Protéines › Protéines membranaires › Early-Stage Contactin-Associated Protein-like...
questionsmedicales.fr › Acides aminés, peptides et protéines › Protéines › Globulines › Sérum-globulines › Immunoglobulines › Anticorps › Autoanticorps › Early-Stage Contactin-Associated Protein-like...
questionsmedicales.fr › Maladies du système nerveux › Encéphalite › Early-Stage Contactin-Associated Protein-like...
questionsmedicales.fr › États, signes et symptômes pathologiques › Signes et symptômes › Manifestations neurologiques › Crises épileptiques › Early-Stage Contactin-Associated Protein-like...
questionsmedicales.fr › États, signes et symptômes pathologiques › Signes et symptômes › Manifestations neurologiques › Névralgie › Early-Stage Contactin-Associated Protein-like...
questionsmedicales.fr › Facteurs biologiques › Antigènes › Antigènes de surface › Molécules d'adhérence cellulaire › Molécules d'adhérence cellulaire neuronale › Contactines › Early-Stage Contactin-Associated Protein-like...