Autoimmune and inflammatory neurological diseases share a common analytical shape in litigation: the clinical presentation is often atypical at the outset, the definitive diagnostic workup is not always pursued early, and treatment efficacy is tightly correlated with how quickly the diagnosis is made and therapy initiated. Guillain-Barré syndrome, myasthenia gravis, autoimmune encephalitis, multiple sclerosis relapses, and related conditions each have distinct clinical signatures, distinct diagnostic protocols, and distinct treatment standards — and most litigated cases turn on whether the presentation was recognized in time, whether the workup was appropriate to the differential, and whether treatment was initiated when the evidence would have supported it. My review of these cases is grounded in active neurology practice, fellowship-level training in these conditions, and the governing neurology and neurocritical-care literature.
Scope
Autoimmune and inflammatory neurology covers the range of immune-mediated conditions where recognition and treatment timing are typically at issue.
- Guillain-Barré syndrome and its variants — including acute inflammatory demyelinating polyneuropathy (AIDP), Miller Fisher syndrome, and related acute immune-mediated neuropathies. The classic case involves questions of early recognition, respiratory monitoring, and the timing of IVIG or plasmapheresis.
- Myasthenia gravis — including myasthenic crisis, thymoma-associated presentations, and the differential diagnostic considerations when the presentation is atypical or when medications have interacted with neuromuscular transmission.
- Autoimmune encephalitis — including NMDA-receptor and related antibody-mediated encephalitides, paraneoplastic syndromes, and the diagnostic framework when the initial presentation resembles a primary psychiatric illness.
- Multiple sclerosis and CNS demyelinating disease — including acute relapses, treatment-related complications, and the diagnostic distinction between MS and its mimics.
- Other immune-mediated CNS and PNS conditions — including chronic inflammatory demyelinating polyneuropathy (CIDP), neuromyelitis optica spectrum disorder (NMOSD), and related conditions where recognition and treatment timing are at issue.
Engagement
Autoimmune neurology cases typically involve extended clinical timelines — multiple providers, incremental diagnostic workup, and treatments started late.
- Pre-retention case consultation — a structured early conversation before formal engagement.
- Records review with written analysis — structured review and written analytical summary.
- Independent medical examination (IME) — in-person or video examination, conducted under ABIME standards, with a structured written report.
- Expert report — formal written expert report suitable for disclosure.
- Deposition and trial testimony — testimony consistent with the written record.
I review for plaintiff and defense counsel on an independent basis. I decline cases outside my clinical domain, cases where the record will not support the opinion sought, and cases where my schedule will not permit the attention the work requires.
Related Writings
Writings on autoimmune & inflammatory neurology are in development and will appear here as they publish. In the meantime, see the broader Writings for pieces on related clinical domains.