limbic encephalitis
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Etiology
- autimmune mediators:
- intracellular autoantigens:
- cell-surface autoantigens
- paraneoplastic limbic encephalitis
- Herpes simplex encephalitis
Epidemiology
rare
Pathology
- neuronal loss in medial temporal lobe & elsewhere in the limbic system
- perivascular & meningeal lymphocytic infiltration
Clinical manifestations
- symptoms evolve over weeks
- memory impairment, amnesia, confusion[1]
- personality change
- psychosis
- encephalopathy
- temporal lobe seizures
Laboratory
- serum sodium may show hyponatremia[1]
- CSF analysis may show lymphocytic pleocytosis
Diagnostic procedures
- EEG may be abnormal
- case presentation with nonconvulsive status epilepticus[1]
Radiology
- neuroimaging
- MRI may be abnormal in temporal lobe
Management
- treat empirically with intravenous acyclovir for Herpes simplex encephalitis until diagnosis is clarified[1]
- intracellular autoantigen (+)
- generally refractory to therapy
- cell-surface autoantigen (+)
- removal of tumor
- glucocorticoids
- IV gamma-globulin
- plasmapheresis
More general terms
More specific terms
Additional terms
References
- ↑ 1.0 1.1 1.2 1.3 1.4 Medical Knowledge Self Assessment Program (MKSAP) 16, 18. American College of Physicians, Philadelphia 2012, 2018
- ↑ Tuzun E & Dalmau J Limbic encephalitis and variants: Classification, diagnosis and treatment. Neurologist 2007, 13:261 PMID: https://www.ncbi.nlm.nih.gov/pubmed/17848866
- ↑ Shin YW, Lee ST, Shin JW et al VGKC-complex/LGI1-antibody encephalitis: clinical manifestations and response to immunotherapy. J Neuroimmunol. 2013 Dec 15;265(1-2):75-81. Epub 2013 Oct 17. PMID: https://www.ncbi.nlm.nih.gov/pubmed/24176648