Course and outcome of acute limbic encephalitis with negative voltage-gated potassium channel antibodies

被引:44
作者
Samarasekera, S. R.
Vincent, A.
Welch, J. L.
Jackson, M.
Nichols, P.
Griffiths, T. D.
机构
[1] Newcastle Univ, Sch Med, Newcastle Upon Tyne NE2 4HH, Tyne & Wear, England
[2] Royal Victoria Infirm, Dept Neurol, Newcastle Upon Tyne NE1 4LP, Tyne & Wear, England
[3] Univ Oxford, Dept Clin Neurol, Oxford, England
[4] Newcastle Gen Hosp, Dept Neuropsychol, Newcastle Upon Tyne NE4 6BE, Tyne & Wear, England
[5] Newcastle Gen Hosp, Dept Neurol, Newcastle Upon Tyne NE4 6BE, Tyne & Wear, England
关键词
D O I
10.1136/jnnp.2006.093096
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background: Limbic encephalitis is a potentially treatable immunological condition. The presence of voltage-gated potassium channel antibodies (VGKC-Ab) in the cerebrospinal fluid (CSF) and serum of patients with the condition is a marker of the disease associated with a non-paraneoplastic form and good response to treatment. Recent work has highlighted absent serum VGKC-Ab and distinct immunology in patients with the paraneoplastic form of limbic encephalitis. Methods: The cases of four patients with the typical clinical presentation, neuropsychological features and brain imaging of acute limbic encephalitis, in the absence of any evidence for associated cancer during a follow-up of at least 18 months are described here. Results: All patients had negative testing for VGKC-Ab measured during their acute presentation. All patients made some recovery, although they were left with marked cognitive deficits and persistent seizures. Conclusion: These cases demonstrate that the absence of VGKC-Ab in limbic encephalitis does not necessarily imply a paraneoplastic form. Further work is required to establish the immunological basis for the disorder in these patients, and the optimal treatment regimen.
引用
收藏
页码:391 / 394
页数:4
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