Where it is reported at all, follow up time varies across studies, and this situation is complicated by the fact that different authors use different criteria for establishing the presence of HE (making it difficult to compare findings across studies).

​

Bearing that in mind, some patients are able to achieve remission and significant restoration of lost capabilities via immunotherapy. As with other forms of brain injury, the resolution of overt neurological signs and deficits may recede a patient's ability to resume all prior daily activities.

​

However, case studies that do include long-term follow-up report a high incidence of recurrence, consistent with the fluctuation patterns of a relapsing-remitting autoimmune disease rather than a spontaneous "cure." The literature also includes descriptions of a progressive type of HE, in which immunotherapies may slow or halt the progression of the illness but do not appear to restore any capabilities already lost.

​

What is the overall long-term prognosis for patients with HE?

​

Long-term prognosis depends on the severity and type of HE and the demands of the patient's lifestyle. Some patients ultimately achieve remission with few, if any, residual deficits, and are able to carry on with life. However, those with relapsing-remitting HE or with significant residual deficits may be unable to maintain their careers. This is particularly true for those whose professions require good communications skills, strong memory, the ability to concentrate and the consistent performance.

​

HE patients who suffer from ongoing seizures or seizure-like events, in which they may suddenly lose balance and focus, can pose serious safety risks to themselves and others, and pediatric HE patients may be at higher risk of developing status epilepticus (uncontrollable seizures).