Journal List > Dement Neurocogn Disord > v.13(3) > 1120733

TOOLS
Han, Joo, Kang, Ha, and Yang: Non-paraneoplastic Autoantibody-negative Limbic Encephalitis Characterized by Mild Memory Impairment: A Case Report
Case Report

Dementia and Neurocognitive Disorders 2014; 13(3): 79-82.

Published online: 30 September 2014

DOI: https://doi.org/10.12779/dnd.2014.13.3.79

Non-paraneoplastic Autoantibody-negative Limbic Encephalitis Characterized by Mild Memory Impairment: A Case Report

SangWoo Han, M.D., JaeJeong Joo, M.D., JinHo Kang, M.D., Sang won Ha, M.D., YoungSoon Yang, M.D.

Department of Neurology, VHS Medical Center, Seoul, Korea.

Address for correspondence: YoungSoon Yang, M.D. Department of Neurology, VHS Medical Center, 53 Jinhwangdo-ro 61-gil, Gangdong-gu, Seoul 134-791, Korea. Tel: +82-2-2225-4106, Fax: +82-2-2225-4105, astro76@naver.com

Received 22 August 2014       Revised 2 September 2014       Accepted 2 September 2014

© 2014 Korean Dementia Association

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Encephalitis that primarily involves limbic system structures such as the hippocampus and parahippocampal gyrus has been described in early papers, most commonly characterized by a subacute progressive impairment of short-term memory, psychiatric features and seizures. While these findings might be caused by viral infections or systemic autoimmune disorders, many patients with limbic encephalitis have an immune-mediated etiology (paraneoplastic or not) characterized with serum or CSF antineuronal antibodies. This case reports about non-paraneoplastic autoantibody-negative limbic encephalitis in which there are no detection of antigens and no evidence of tumors.

Keywords: Limbic encephalitis, Memory impairment, Non-paraneoplastic, Autoantibody negative

Figures and Tables

Fig. 1
Axial brain MR T2-weighted image (T2WI) and fluid-attenuated inversion recovery (FLAIR) image show increased signal intensity in both medial temporal lobe (A, C). T1-weighted image (T1WI), Gadolium (Gd)-eahauced T1-weighted MRI and DWI study shows no hyperintensity on bilateral temporal lobes with isointensities on ADC map (B, D, E, F).
dnd-13-79-g001
Fig. 2
Brain FDG PET shows increased FDG uptake in the both medial temporal lobes, which is much worse on the left side.
dnd-13-79-g002
Fig. 3
EEG monitoring shows no epileptiform discharge.
dnd-13-79-g003
Fig. 4
Follow-up MRI after 2 weaks. FLAIR image shows some improvement compared to the previous study.
dnd-13-79-g004

References

1. Brierley JB, Corsellis JAN, Hierons R, Nevin S. Subacute encephalitis of alter adult life, mainly affecting the limbic areas. Brain. 1960; 83:357–368.
crossref
2. Kondziella D. Case report on non-paraneoplastic autoantibody-negative limbic encephalitis. http://www.neuropenews.org/?p=65.
3. Won Y, Kim JY, Park HJ. A case of voltage gated potassium channel antibodies-associated nonparaneoplastic limbic encephalitis. J Korean Neurol Assoc. 2006; 24:148–152.
4. Vincent A, Bien CG, Irani SR, Waters P. Autoantibodies associated with diseases of the CNS: new developments and future challenges. Lancet Neurol. 2011; 10:759–772.
crossref
5. Kim MH, Oh SH, Shin DK. Limbic encephalitis caused by human herpesvirus-6 infection in allogenic hematopoietic stem cell transplantation patient. J Korean Neurol Assoc. 2010; 28:132–134.
6. Cho TY, Kim YJ, Lee BI. A case of limbic encephalitis associated with small cell lung? cancer-about diagnostic MRI Findings. J Korean Neurol Assoc. 1994; 12:338–342.
7. Cho HJ, Jo JW, Park KP. A case of paraneoplastic limbic encephalitis associated with immature ovarian teratoma. J Korean Neurol Assoc. 2003; 21:647–650.
8. Han SH, Chi HS. A case of paraneoplastic limbic encephalitis presenting anti-purkinje cell antibody. J Korean Neurol Assoc. 2005; 23:724–726.
9. Gultekin SH, Rosenfeld MR, Voltz R, Eichen J, Posner JB, Dalmau J. Paraneoplastic limbic encephalitis: neurological symptoms, immunologic findings and tumor association in 50 patients. Brain. 2000; 123:1481–1494.
crossref
10. Kim KK. Paraneoplastic syndrome. J Korean Neurol Assoc. 2002; 20:215–222.
11. Lancaster E, Martinez-Hernandez E, Dalmau J. Encephalitis and antibodies to synaptic and neuronal cell surface proteins. Neurology. 2011; 77:179–189.
crossref
12. TUZUN Erdem. Limbic Encephalitis Associated with Antibodies to Cell Membrane Antigens. Arch Neuropsychiatry. 2007; 44:101–107.
TOOLS
Similar articles