@article{ref1,
title="Criminality in patients with autoimmune encephalitis: a case series",
journal="European journal of neurology",
year="2024",
author="Michael, Sophia and Varley, James and Williams, Robyn and Bajorek, Tomasz and Easton, Ava and Irani, Sarosh R.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND AND PURPOSE: Despite it being an immunotherapy-responsive neurological syndrome, patients with autoimmune encephalitis (AE) frequently exhibit residual neurobehavioural features. Here, we report criminal behaviours as a serious and novel postencephalitic association. <br><br>METHODS: This retrospective cohort study included 301 AE patients. Five of who committed crimes underwent direct assessments and records review alongside autoantibody studies. <br><br>RESULTS: Five of 301 patients (1.7%) with AE exhibited criminal behaviours, which included viewing child pornography (n = 3), repeated shoplifting, and conspiracy to commit murder. All five were adult males, with LGI1 autoantibodies (n = 3), CASPR2 autoantibodies, or seronegative AE. None had evidence of premorbid antisocial personality traits or psychiatric disorders. Criminal behaviours began a median of 18 months (range = 15 months-12 years) after encephalitis onset. At the time of crimes, two patients were immunotherapy-naïve, three had been administered late immunotherapies (at 5 weeks-4 months), many neurobehavioural features persisted, and new obsessive behaviours had appeared. However, cognition, seizure, and disability measures had improved, alongside reduced autoantibody levels. <br><br>CONCLUSIONS: Criminal behaviours are a rare, novel, and stigmatizing residual neurobehavioural phenotype in AE, with significant social and legal implications. With caution towards overattribution, we suggest they occur as part of a postencephalitis limbic neurobehavioural syndrome.<p /> <p>Language: en</p>",
language="en",
issn="1351-5101",
doi="10.1111/ene.16197",
url="http://dx.doi.org/10.1111/ene.16197"
}