Seronegative Autoimmune Limbic Encephalitis A Case Report - Video
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Overview
Autoimmune limbic encephalitis (LE) is a subset of acute encephalitis characterized by inflammation of the limbic cerebral cortex. Cognitive decline, behavioral disturbance, and seizures are its cardinal manifestations.
The study in JAPI reports a case of a 70-year-old man with subacute progressive gait imbalance, cognitive impairment, and psychiatric manifestations. Extensive serum and cerebrospinal fluid (CSF) investigations did not reveal any abnormality.
Autoimmune and paraneoplastic encephalitis antibody panels were negative. Magnetic resonance imaging (MRI) and positron emission tomography (PET) brain scans suggested limbic encephalitis. He responded well to immunotherapy.
This case illustrates that acute encephalitis must be suspected in the appropriate setting, even in the absence of a specific antibody. These patients should be given the benefit of early immunotherapy.
All his routine blood investigations, venereal disease research laboratory, HIV, vitamins B1, B12, and E, thyroid profile, and thyroid antibodies were normal. His chest X-ray and abdominal ultrasound were normal. His systemic and paraneoplastic antibody and tumor marker profiles were also negative. The MRI and PET brain scans were normal. As his symptoms were mild and did not impact his daily activities, he was sent home. Unfortunately, he was lost to follow-up for 6 months.
This case brings the importance of remaining vigilant to the possibility of acute encephalitis, even if antibody panels are negative. Seronegative acute encephalitis can be diagnosed on clinical grounds along with ancillary investigations. A delay in diagnosis leads to poor outcomes, so a high index of suspicion is required for its diagnosis.
Reference: Aendole D, Lalkaka J, Jade J, et al. Seronegative Autoimmune Limbic Encephalitis: A Case Report. J Assoc Physicians India 2022;70 (9):88–89.
Speakers
Dr. Nandita Mohan
BDS, MDS( Pedodontics and Preventive Dentistry)
Dr. Nandita Mohan is a practicing pediatric dentist with more than 5 years of clinical work experience. Along with this, she is equally interested in keeping herself up to date about the latest developments in the field of medicine and dentistry which is the driving force for her to be in association with Medical Dialogues. She also has her name attached with many publications; both national and international. She has pursued her BDS from Rajiv Gandhi University of Health Sciences, Bangalore and later went to enter her dream specialty (MDS) in the Department of Pedodontics and Preventive Dentistry from Pt. B.D. Sharma University of Health Sciences. Through all the years of experience, her core interest in learning something new has never stopped. She can be contacted at editorial@medicaldialogues.in. Contact no. 011-43720751
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751
