Emerging Subspecialties in Neurology: Autoimmune neurology

Autoimmune neurology is one of the most rapidly evolving fields in modern neurology. Autoantibodies that recognize nervous system self-antigens, including ion channels, receptors for neurotransmitters, and neuronal intrinsic and extrinsic proteins involved in synaptic transmission, are all recognized as targets of pathogenic autoantibodies. The accelerating rate of new antigen discovery in recent decades is impressive (figure). The diversity of neurologic presentations, the unique pathophysiology, and the complexity of treating these disorders justifies dedicated fellowship training to acquire the expertise needed to diagnose and optimally manage these patients. The requisite training is distinct from the classical exposure provided by traditional neuroimmunology fellowships that focus on multiple sclerosis. As a new subspecialty, autoimmune neurology intersects all neurologic subspecialties and other medical specialties, including but not limited to clinical immunology, infectious disease, rheumatology, gastroenterology, oncology, and psychiatry. While this article focuses on autoimmune neurology fellowships currently available in the United States, historically many current leaders in the field trained nationally and internationally under Dr. Jerome Posner, Dr. John Newsom-Davis, and Dr. John Trotter, to name a few of the pioneers.