Seizure: European Journal of Epilepsy
Volume 19, Issue 7 , Pages 446-449, September 2010

Non-paraneoplastic limbic encephalitis characterized by mesio-temporal seizures and extratemporal lesions: A case report

  • Vittoria Cianci

      Affiliations

    • Institute of Neurology, Magna Græcia University of Catanzaro, Italy
    • Magna Græcia University of Catanzaro; Regional Epilepsy Center, Italy
    • ,
  • Angelo Labate

      Affiliations

    • Institute of Neurology, Magna Græcia University of Catanzaro, Italy
    • ,
  • Pierluigi Lanza

      Affiliations

    • National Research Council, Piano Lago–Mangone, Cosenza, Italy
    • ,
  • Angela Vincent

      Affiliations

    • Neurosciences Group, Weatherall Institute of Molecular Medicine, University of Oxford, John Radcliffe Hospital, Department of Clinical Neurology, England, United Kingdom
    • ,
  • Antonio Gambardella

      Affiliations

    • Institute of Neurology, Magna Græcia University of Catanzaro, Italy
    • National Research Council, Piano Lago–Mangone, Cosenza, Italy
    • ,
  • Damiano Branca

      Affiliations

    • Neurological Unit, “Riuniti” Hospital of Reggio Calabria, Italy
    • ,
  • Luciano Arcudi

      Affiliations

    • Neurological Unit, “Riuniti” Hospital of Reggio Calabria, Italy
    • ,
  • Umberto Aguglia

      Affiliations

    • Institute of Neurology, Magna Græcia University of Catanzaro, Italy
    • Magna Græcia University of Catanzaro; Regional Epilepsy Center, Italy
    • Corresponding Author InformationCorresponding author at: Centro Regionale Epilessie, Presidio Riuniti, Via Melacrino, 89100, Reggio Cal., Italy. Tel.: +39 333 3167327; fax: +39 0965 397973.

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.

Keywords: Antibodies, Epilepsy, GAD, Limbic encephalitis, Magnetic resonance imaging, Seizures

 

PII: S1059-1311(10)00116-0

doi:10.1016/j.seizure.2010.06.002

Seizure: European Journal of Epilepsy
Volume 19, Issue 7 , Pages 446-449, September 2010

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