Graus Criteria (Autoimmune Encephalitis)
Applies the Graus 2016 criteria for possible autoimmune encephalitis and definite autoimmune limbic encephalitis.
Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- Subacute onset under 3 months
- Yes
- Seizures not previously explained
- Yes
- Alternative causes excluded
- Yes
Result: possible autoimmune encephalitis
The tool opens with these values already filled in. Replace them with your own.
What the result means
- Possible AE 1
- Subacute onset, progressing over less than 3 months, of working memory deficits, altered mental status or psychiatric symptoms.
- Possible AE 2
- At least ONE of: new focal CNS findings; seizures not explained by a known seizure disorder; CSF pleocytosis; MRI features suggestive of encephalitis.
- Possible AE 3
- Reasonable exclusion of alternative causes.
- Definite limbic
- All four: subacute limbic presentation; bilateral T2-FLAIR change highly restricted to the medial temporal lobes; CSF pleocytosis or a temporal EEG abnormality; exclusion.
- No antibody
- Neither set includes serology, by design. Results take weeks and antibody-negative disease is real, so waiting for them delays treatment. A negative antibody does not undo the diagnosis.
- The MRI asymmetry
- A suggestive MRI is one of four alternatives for possible AE and mandatory for the definite limbic form. A normal scan leaves the first open and rules the second out.
- Pleocytosis
- MORE than 5 white cells per cubic mm. Exactly 5 does not count.
- The main mimic
- Herpes simplex encephalitis. Its CSF PCR can be falsely negative within the first 24 hours and should be repeated if suspicion stays high.
What you enter
- Subacute onset under 3 months
- Presentation suggests limbic involvement
- New focal CNS findings
- Seizures not previously explained
- CSF white cells per mm3
- MRI suggestive of encephalitis
- Bilateral medial temporal T2-FLAIR change
- Temporal epileptic or slow-wave EEG
- Alternative causes excluded
How this is calculated
Graus F, Titulaer MJ, Balu R, et al. A clinical approach to diagnosis of autoimmune encephalitis. Lancet Neurol. 2016;15(4):391-404. Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.