Non-paraneoplastic limbic encephalitis characterized by mesio-temporal seizures and extratemporal lesions: A case report
Received 12 December 2009; received in revised form 21 May 2010; accepted 4 June 2010. published online 02 July 2010.
Abstract
Limbic encephalitis (LE) can be either paraneoplastic or a non-paraneoplastic autoimmune disorder. Magnetic resonance imaging (MRI) of the brain on T2-weighted fluid-attenuated inversion recovery (FLAIR) classically shows hyperintensities of the temporal structures, but multifocal involvement of extratemporal cortex has also been described in paraneoplastic LE. Here we describe a 27-year-old woman whose idiopathic autoimmune (glutamic acid decarboxylase-antibody positive) LE debuted with multiple daily mesio-temporal seizures, amnesia and multifocal extratemporal cortical MRI abnormalities. Mesio-temporal MRI signal increase was found after 20 days. This case report highlights that early diagnosis of non-paraneoplastic LE may be considered in patients with multiple daily mesio-temporal seizures and amnesia even in the absence of early typical MRI abnormalities.
aInstitute of Neurology, Magna Græcia University of Catanzaro, Italy
bMagna Græcia University of Catanzaro; Regional Epilepsy Center, Italy
cNeurological Unit, “Riuniti” Hospital of Reggio Calabria, Italy
dNational Research Council, Piano Lago–Mangone, Cosenza, Italy
eNeurosciences Group, Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital, Department of Clinical Neurology, England, United Kingdom
Corresponding author at: Centro Regionale Epilessie, Presidio Riuniti, Via Melacrino, 89100, Reggio Cal., Italy. Tel.: +39 333 3167327; fax: +39 0965 397973.
ABSTRACT