Abstract | INTRODUCTION:
Autoimmune limbic encephalitis is an inflammatory condition often associated with an underlying neoplasm. However, a subset of patients does not have an underlying tumor and have a nonparaneoplastic form of this condition. The focus in the literature has been on the acute phase of this illness, but long-term follow-up is lacking. METHODS: A retrospective chart review, over a period of 15 years, of patients carrying a diagnosis of encephalitis was performed. Inclusion criteria included a clinical presentation consistent with limbic encephalitis (subacute behavioral change, seizures, or anterograde memory decline) and an identifiable autoantibody, inflammatory CSF (>5 white blood cells/mm(3)), or limbic hyperintensities on MRI. Readmission rates and long-term psychiatric, psychosocial, and seizure outcomes were evaluated. RESULTS: A total of 16 patients were identified. Clinical presentation included new-onset seizures in 14 (88%), behavioral changes in 7 (44%), and memory decline in 5 (31%). Four (25%) patients presented with status epilepticus. Five patients had antibodies against NMDAR ( N-methyl-D-aspartate receptor) and four against VGKC ( voltage gated potassium channel) complex. An inflammatory CSF was noted in 7 (44%) and MRI changes in 9 (56%). Four were readmitted during the follow-up period. Around half the patients continued to have medically drug/treatment-refractory seizures, while 7 (44%) had a new psychiatric diagnosis ( mood disorder, anxiety disorder, or impulse control disorder). The majority of the patients continued to reside at home, while 43% of previously employed patients lost employment. CONCLUSION:
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Authors | Rani A Sarkis, Romy Nehme, Zeina N Chemali |
Journal | Epilepsy & behavior : E&B
(Epilepsy Behav)
Vol. 39
Pg. 21-5
(Oct 2014)
ISSN: 1525-5069 [Electronic] United States |
PMID | 25171259
(Publication Type: Journal Article)
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Copyright | Copyright © 2014 Elsevier Inc. All rights reserved. |
Chemical References |
- Potassium Channels, Voltage-Gated
- Receptors, N-Methyl-D-Aspartate
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Anxiety Disorders
(etiology)
- Autoimmune Diseases
(complications)
- Disease Progression
- Disruptive, Impulse Control, and Conduct Disorders
(etiology)
- Drug Resistance
- Employment
(statistics & numerical data)
- Female
- Humans
- Limbic Encephalitis
(complications)
- Longitudinal Studies
- Male
- Middle Aged
- Mood Disorders
(etiology)
- Potassium Channels, Voltage-Gated
(immunology)
- Receptors, N-Methyl-D-Aspartate
(immunology)
- Recurrence
- Seizures
(etiology)
- Young Adult
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