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

SangWoo Han; JaeJeong Joo; JinHo Kang; Sang won Ha; YoungSoon Yang

doi:10.12779/dnd.2014.13.3.79

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

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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

(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).

Fig. 2

Brain FDG PET shows increased FDG uptake in the both medial temporal lobes, which is much worse on the left side.

Fig. 3

EEG monitoring shows no epileptiform discharge.

Fig. 4

Follow-up MRI after 2 weaks. FLAIR image shows some improvement compared to the previous study.

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