The Encephalitis Conference two-day event remains the largest of its kind worldwide, bringing together 515 delegates across 71 countries this year, virtually and in person, at the prestigious Royal College of Physicians in London. People across scientific and clinical disciplines, from students to experts, assemble to shape the landscape of encephalitis by exchanging knowledge and ideas.
The first day started with an overview of encephalitis. A breakdown of infectious encephalitis was given by Prof Benedict Michael (University of Liverpool, UK), and Prof Sarosh Irani (Mayo Clinic Florida, USA) joining virtually, provided an overview of autoimmune encephalitis. A new addition this year was the second session -an exciting case-based discussion that aimed to challenge delegates’ understanding of encephalitis. The session was moderated by a panel of global experts in encephalitis, including Assoc Prof Stacey Clardy (University of Utah, USA), Prof Arun Venkatesan (Johns Hopkins University School of Medicine, USA), Dr Nick Davies (Chelsea and Westminster Hospital, London, UK) and Prof Gagandeep Singh (Dayanand Medical College, Ludhiana, India). Dr Crystal Sing Chiek Teoh (Nottingham University Hospitals, UK), Dr Enrique Steff Hernández Rojas (Federico Lleras Acosta Hospital, Colombia), Dr Sobia Khan (Aga Khan University, Pakistan) and Dr Neil Watson (Royal Infirmary of Edinburgh, UK) presented a suspected encephalitis of unknown aetiology case, a Dengue encephalitis case, a classic case of Varicella Zoster Virus (VZV) encephalitis, and respectively a rare case of encephalitic neuroborreliosis.
In the third session, Assoc Prof Deanna Saylor (Johns Hopkins University School of Medicine, USA & University Teaching Hospital, Zambia), Dr Saif Huda (Walton Centre Foundation Trust and University of Liverpool UK) and Dr Mashina Chomba (University Teaching Hospital, Lusaka, Zambia) shared their experiences of how to get grants and fellowships in both high and low and middle-income settings. Their tips included being passionate and proactive, willing to try new things and persevering to keep going, even in the face of grant and paper rejections, demonstrating novelty, project feasibility and a proven track record, networking with researchers, and utilising existing data such as patient registries.
The fourth session was a data blitz chaired by Prof Michael Wilson (UCSF Weill Institute for Neurosciences, USA), Dr Sophie Binks (University of Oxford, UK) and Dr Thomas Pollak (King’s College London, UK). The session featured 12 speakers from nine countries presenting fascinating research including the role of brain biopsy in seronegative autoimmune encephalitis; the pathogenesis of CASPR2 autoantibodies; the mechanisms of the brain injury in SARS-COV-2; factors associated with a delayed diagnosis and poor outcomes; prognostic factors of West Nile virus neuroinvasive disease and infectious encephalitis; an update on the ongoing ExTINGUISH trial, currently in phase 2b; acute symptomatic seizures in autoimmune encephalitis; markers of LGI-1 and CASPR2-associated disease; bacterial meningoencephalitis; diagnostic value of metagenomics in CNS infection; and the epidemiology of arboviral encephalitis in a tertiary setting in Pakistan. Day One concluded with poster viewing (44 posters from 15 countries) and a drinks and networking reception.
The first session of Day Two was chaired by Dr James Sejvar (University of Pittsburgh, USA) together with Professor Angela Vincent (University of Oxford, UK). The first keynote lecture of the day was by Dr Marianna Spatola (University of Barcelona and La Caixa Research Institute, Spain) who presented an impressive work on functional effects of antibodies in infectious and autoimmune encephalitis. She showed functional differences of antibodies between pulmonary tuberculosis and tuberculous meningoencephalitis and how CASPR2 antibodies have different features based on phenotypes. Although some of the observed antibody effects are protective, this needs to be studied more.
In the next talk, Dr Sarah Crisp (University of Cambridge, UK) demonstrated DPPX IgGs causing hyperexcitability in rat hippocampal neurons by causing internalisation of its associated Kv4.2 potassium channel. As such, whether anticonvulsants could play a role in DPPX encephalitis is yet to be seen.
Next was Dr Thomas Hughes (University of Liverpool, UK), joining remotely to present his work on validating the UK seizure risk score internationally. Though there were under-representations from some parts of the world, his findings made it apparent that countries need to develop their local score due to huge variations in epidemiology, leading to different infectious aetiologies that largely influence the score.
Next on the stage, Ms Hannah Tenenbaum (Charite—Universitatsmedizin Berlin, Germany) observed in her doctoral work persistent cerebral atrophy in some patients beyond four years post anti-NMDAR encephalitis and that this was associated with severe neuropsychiatric outcomes. A follow-up study would be useful to determine if this atrophy is due to an ongoing neuronal injury.
Dr Steven L. Staal (University of Amsterdam, The Netherlands) proposed revised diagnostic criteria for encephalitis that could be useful in clinical settings in contrast to the one suggested by the International Encephalitis Consortium in 2013 for epidemiological and research purposes. Surprisingly, focal neurology was not featured in these revised criteria, although it needs to be further validated. To further buttress that the pre-existing encephalitis criteria need to be revised, Dr Ralph Habis (Johns Hopkins University School of Medicine, Baltimore, USA) highlighted how cognitive bias could lead to patients with primary psychiatric problems being exposed to unnecessary immunotherapy and how those with infectious encephalitis presenting with new psychiatric symptoms could be missed.
The second session was chaired by Dr Nicholas Davies (Chelsea and Westminster Hospital, London, UK) and Prof Arun Venkatesan (Johns Hopkins University School of Medicine, Baltimore, USA). Invited guest lecturer Prof Tom Solomon CBE (The Pandemic Institute; National Institute for Health and Care Research Health Protection Research Unit in Emerging and Zoonotic Infections, Liverpool, UK) kicked off the session by updating the audience on the DexEnceph study, which now elaborated that early treatment with corticosteroids, especially within the first ten days, may improve patient outcomes.
Dr Manoj Upadhya (Aston University, Birmingham, UK) presented initial findings showing how rat models could be used to study the mechanism underpinning Glycine-receptor antibody-mediated CNS disease. Joining remotely was Ms Maria Jose (National Institute of Mental Health and Neurosciences, Bengaluru, India) who highlighted the need for screening for Chikungunya Virus (CHKV) in children presenting with Acute Encephalitic Syndrome in Southern India outside of epidemic periods. Besides demonstrating that several children in their cohort had CHKV causing encephalitis, sequencing of the virus showed it is of the ECSA genotype, which recent studies have shown to be neurotropic.
Dr Rachael Brown (University College London, UK) presented her doctoral work, which showed the potential role of T cell immune response in anti-NMDAR encephalitis. If replicated in a larger and more homogenous cohort, it could be an avenue to explore other therapeutic strategies.
An update on the aetiologies of meningitis and encephalitis in a high HIV prevalence setting was provided by Dr Lerato Mambulu (Kamuzu Central Hospital, Malawi). Although limited by diagnostic challenges, she noted how old age, male sex, HIV positivity, TB meningitis and cryptococcal meningitis were associated with adverse outcomes in these cohorts of patients. Just before lunch, Dr Ava Easton, (Encephalitis International and University of Liverpool, UK), gave a whistlestop tour of patient outcomes and quality of life as well as an overview of Encephalitis International’s focus and various means through which it achieves its goals in a talk titled “Brains on Fire”. The organisation is dedicated to supporting affected patients, raising awareness among the public through campaigns, and funding research in encephalitis to improve patient outcomes.
Dr Matteo Gastaldi (University of Pavia, Italy) and Assoc Prof Kiran Thakur (Columbia University, USA) chaired session three. It began with the second keynote lecture by Prof Michael Wilson (UCSF Weill Institute for Neurosciences, USA) on metagenomics next generation sequencing (mNGS). His talk highlighted how mNGS plays a key role in identifying the infectious aetiology of encephalitis in most of those missed by conventional methods. Consequently, it can be seen as a crucial tool that could aid in detecting emerging infections of global importance. He advised on the need to interpret results with caution due to the possibility of false positives.
The session now took an interesting dimension involving a finance talk. This is where Dr Thomas Agerbo Gaist (Odense University Hospital, Denmark) shared his early findings on a retrospective study using the national Danish registry where he observed secondary care costs taking the large chunk of the expenses. However, autoimmune encephalitis was observed to be more cost-intensive than HSV1 encephalitis, mostly due to outpatient visits and investigations demand.
Assoc Prof Priyanka Madaan (Amrita Institute of Medical Sciences, India) is a testament to Encephalitis International supporting research. She received seed funding for her research to develop a Paediatric Autoimmune Encephalitis Severity Score (PASS) in children with autoimmune encephalitis. This came from the observation that previous scales used did not consider non-motor milestones. It however needs to be validated further in a larger cohort.
Now came the awaited electrifying debate between Dr Mashina Chomba (University Teaching Hospital, Zambia) supporting the motion that “Encephalitis Research Fails to Improve Diagnosis and Treatment in Low-to-Middle Income Countries (LMIC)” and Prof Gagandeep Singh (Dayanand Medical College, India) who opposed the motion. Dr Chomba gave a convincing speech on how most of the research is done in high-income countries (HIC) when LMIC bears the greatest disease burden. Moreover, the difference in epidemiology among these regions means results from HIC may not directly apply to the LMIC. Prof Singh also agreed that more research is needed in LMIC but gave a compelling argument using an example where the discovery of a novel viral aetiology of encephalitis in a certain region of India led to a drastic reduction in paediatric mortality. The house was initially undecided but changed its stance in favour of supporting the motion after the debate.
Dr Ole Jonas Boeken (Charite Universitatsmedizin, Berlin, Germany) gave us an update on the SAPIENCE project looking at the social and psychological long-term impact of NMDA receptor encephalitis, emphasising the need to consider the caregiver’s perspective. The second guest lecture was by Dr Bhagteshwar Singh (University of Liverpool, UK) who presented the work he did during his PhD thesis, which elaborated on the need to involve stakeholders across all stages of a patient’s journey to improve the management of people with brain infections in LMIC.
As the conference came to an end, Phillippa Chapman, deputy CEO Encephalitis International, gave a run-through of how the non-profit’s year has been from awareness campaigns, supporting patients, events, and promoting research. Dr Ava Easton awarded prizes for best oral presentation, best poster and best datablitz, alongside Dr Nicholas Davies, who Professor Benedict Michael succeeds as the Chair of the Encephalitis International Advisory Scientific Panel.
The prize winner for the best oral presentation was Ms Hannah Tennenbaum (Charite Universitatsmedizin, Berlin, Germany). Dr Jeroen Kerstens (Erasmus MC University Medical Center, The Netherlands) and Niels Vander Elst (Karolinska Institute, Sweden) were awarded the best poster presentations and Pietro Businaro (University of Pavia, Italy) won best datablitz presentation.
This marked the end of this thrilling conference, assembling people invested in improving the diagnosis and management of encephalitis globally. The next Encephalitis Conference will be held both virtually and in person at the Royal College of Physicians, London, UK on the 3rd and 4th of December 2025. Enjoy free membership of the Encephalitis Community at: www.encephalitis.info/professional-membership to receive the latest updates on research, campaigns, funding opportunities, and early-bird access to the 2025 conference.
Event sponsors: UCB, Arialys Therapeutics, Roche, Argenx, Research for Ronan, Valneva, Svar Wieslab, Euroimmun, The ExTINGUISH NMDAR Encephalitis Trial, University of Liverpool Institute of Infection, Veterinary and Ecological Sciences, Delve Bio, bioMérieux, James Tudor Foundation, Thriplow Charitable Trust, The Lancet Neurology, ACNR, Routledge
