Serial MRI of limbic encephalitis

Urbach, Horst; Soeder, Bettina M.; Jeub, Monika; Klockgether, Thomas; Meyer, Bernhard; Bien, Christian G.

doi:10.1007/s00234-006-0069-0

Cited by 158 publications

(103 citation statements)

References 24 publications

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“…5 Furthermore, while some authors have indicated that autoimmune VGKC encephalitis may present as a monophasic illness, others have reported progression, with patients shown to develop bilateral temporal lobe involvement with time. 18,19 Our imaging study would support the finding that radiologic progression is common because greater than a quarter (28.6%) of our patients with initially negative study findings or only unilateral findings progressed to bilateral involvement. Whether these changes represent pathology due to persistent CNS inflammation, reflect damage done secondarily by recurrent seizures, or both remains unclear, and prospective longitudinal follow-up will be required to answer this question.…”

Section: Discussionsupporting

confidence: 78%

“…These findings are nonspecific and are similar to those associated with infectious limbic encephalitis 15 and diverse paraneoplastic limbic encephalitides 2,16 and to those demonstrated in several smaller series of autoimmune VGKC encephalitis. 1,[8][9][10]17,18 Our study emphasizes the need to include autoimmune VGKC encephalitis in the differential diagnosis of patients presenting with these MR imaging findings.…”

Section: Discussionmentioning

confidence: 75%

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MRI Findings in Autoimmune Voltage-Gated Potassium Channel Complex Encephalitis with Seizures: One Potential Etiology for Mesial Temporal Sclerosis

Kotsenas¹,

Watson²,

Pittock

et al. 2013

AJNR Am J Neuroradiol

114

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BACKGROUND AND PURPOSE:Autoimmune voltage-gated potassium channel complex encephalitis is a common form of autoimmune encephalitis. Patients with seizures due to this form of encephalitis commonly have medically intractable epilepsy and may require immunotherapy to control seizures. It is important that radiologists recognize imaging characteristics of this type of autoimmune encephalitis and suggest it in the differential diagnosis because this seizure etiology is likely under-recognized. Our purpose was to characterize MR imaging findings in this patient population.

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Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 75%

MRI Findings in Autoimmune Voltage-Gated Potassium Channel Complex Encephalitis with Seizures: One Potential Etiology for Mesial Temporal Sclerosis

Kotsenas¹,

Watson²,

Pittock

et al. 2013

AJNR Am J Neuroradiol

114

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“…The most characteristic alterations in the acute LE phase were edema and T2/FLAIR hyperintensity of the hippocampus typical of LE [11,28,29]. We did not find extratemporal lesions, i.e.…”

Section: Discussionmentioning

confidence: 45%

“…The putamen is actively involved in a variety of cognitive functions such as episodic memory, cognitive control and category learning [38], and its inter-connection with frontal areas and hippocampus play an important role in cognition [39,40]. Hyperintensities previously published in VGKC and LGI1 encephalitis/FBDS pointed to the affection of these structures, and a very recent study reported correlation between longer duration of FBDS and pallidum volume [9,14,[28][29][30]. Although we found decreased hippocampal volumes compared to matched controls, hippocampal volumetry did not correlate with ACE and mRS outcomes.…”

Section: Accepted Manuscript 12mentioning

confidence: 99%

Global brain atrophy and metabolic dysfunction in LGI1 encephalitis: A prospective multimodal MRI study

Szőts

Blaabjerg

Orsi

et al. 2017

Journal of the Neurological Sciences

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Background: Chronic cognitive deficits are frequent in leucin-rich glioma-inactivated 1 protein (LGI1) encephalitis. We examined structural and metabolic brain abnormalities following LGI1 encephalitis and correlated findings with acute and follow-up clinical outcomes. Methods:Nine patients underwent prospective multimodal 3 Tesla MRI 33.1±18 months after disease onset, including automated volumetry, diffusion tensor imaging (DTI) and magnetic resonance spectroscopy (MRS). Data were compared to 9 age-and sex-matched healthy controls. Conclusions:Poor clinical outcome following LGI1 encephalitis is associated with global brain atrophy and disintegration of white matter tracts. The pathological changes affect not only temporomesial structures but also frontal lobes and the cerebellum.

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“…The former category is related to cancer (paraneoplastic limbic encephalitis), showing limited response to immunomodulatory therapy whereas the latter category is autoimmune in nature being less frequently associated with tumours and responding significantly better to immunomodulatory therapy. It has also been recognized that some patients presenting with limbic encephalitis with negative antibody screen in serum and CSF show full recovery after treatment with steroids or immunomodulatory therapy indicating an autoimmune etiology [8,9].…”

Section: Introductionmentioning

confidence: 99%

A Case of Limbic Encephalitis: Antibody LGI1 Associated Encephalitis

Bhardwaj¹,

Sharma²

2016

J Neurol Neurosci

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Limbic encephalitis (LE) is a rarely encountered disease in modern clinical practice. It is basically autoimmune in nature, with its pathophysiology determined by a number of antibodies to neural surface proteins. However, 20% of cases are paraneoplastic and have a tumour source in the body which leads to limbic encephalitis secondarily. Studies have shown that VGKC complex (Voltage Gated Potassium Channels) is one of the common antibodies found in this disease and is represented by three such proteins out of which LGI1 is most prevalent in limbic encephalitis. This entity is characterized by monophasic presentation with acute or subacute onset memory loss, confusion, seizures and psychiatric symptoms. The presence of anti LGI1 antibodies in serum or CSF confirms the diagnosis. We hereby report a case of a 65 year old woman with 8 months history of peripheral neuropathy followed by memory impairment, focal seizures with behavioural and psychiatric changes. No tumour was found on imaging and the classic paraneoplastic panel was negative. However, she was found to be positive for Antibody LGI1 proving autoimmune basis of her illness which responded majorly to immuno-modulatory therapy in the form of high dose steroids.

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Serial MRI of limbic encephalitis

Cited by 158 publications

References 24 publications

MRI Findings in Autoimmune Voltage-Gated Potassium Channel Complex Encephalitis with Seizures: One Potential Etiology for Mesial Temporal Sclerosis

MRI Findings in Autoimmune Voltage-Gated Potassium Channel Complex Encephalitis with Seizures: One Potential Etiology for Mesial Temporal Sclerosis

Global brain atrophy and metabolic dysfunction in LGI1 encephalitis: A prospective multimodal MRI study

A Case of Limbic Encephalitis: Antibody LGI1 Associated Encephalitis

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