Abstract:We report the case of a 55-year-old man presenting pseudopsychiatric behavior disorders of subacute-onset. MRI showed a FLAIR (fluid-attenuated inversion recovery) hyperintensity in the left hippocampus. The diagnosis of limbic encephalitis was raised, and the patient was referred for an 18F-FDG PET/CT. PET/CT depicted an increased uptake of the left mesiotemporal structures and also an increased uptake of both cerebellum and striatal areas. This pattern was compatible with an anti–leucine-rich glioma-inactiva… Show more
Bei der limbischen Enzephalitis liefert die zerebrale FDG-PET essenzielle
Informationen zur Unterstützung von Diagnose, Prognose und
Therapiekontrolle. Mit zunehmender Bedeutung der limbischen Enzephalitis als
„not to miss“-Diagnose wird der Stellenwert der zerebralen
FDG-PET bei dieser Fragestellung weiter steigen. Zudem kommt der
FDG-PET-Ganzkörperaufnahme bei Verdacht auf eine paraneoplastische
Genese und unauffälligem Tumorscreening in den Routineuntersuchungen
eine Schlüsselrolle zu.
Bei der limbischen Enzephalitis liefert die zerebrale FDG-PET essenzielle
Informationen zur Unterstützung von Diagnose, Prognose und
Therapiekontrolle. Mit zunehmender Bedeutung der limbischen Enzephalitis als
„not to miss“-Diagnose wird der Stellenwert der zerebralen
FDG-PET bei dieser Fragestellung weiter steigen. Zudem kommt der
FDG-PET-Ganzkörperaufnahme bei Verdacht auf eine paraneoplastische
Genese und unauffälligem Tumorscreening in den Routineuntersuchungen
eine Schlüsselrolle zu.
“…Brain 18 F-FDG-PET imaging reports uncovered abnormal metabolic patterns of anti-VGKC encephalitis, which may be symptom-specific. [14][15][16][17] In the total of 34 patients, basal ganglia hypermetabolism was observed in 28 subjects (82%), and 68% of patients showed medial temporal lobe (MTL) hypermetabolism, the pattern of which appeared earlier than in MRI. It has also been reported that isolated basal ganglia hypermetabolism was more frequently observed in subjects with FBDS (Figures 1 and 2).…”
Autoimmune encephalitis is an immune-mediated inflammatory disease of the central nervous system caused by abnormal immune response against surface or intracellular antigens. 1 In addition to the previously discovered classical paraneoplastic encephalitisassociated antibodies, a variety of autoimmune encephalitis-related antibodies have been reported in recent years, including antibodies targeting N-methyld-aspartate receptor (NMDAR), alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor (AMPAR), leucine-rich glioma inactivated 1 (LGI1), contactin-associated proteinlike 2 (CASPR2), gamma-aminobutyric acid receptor (GABAR) A/B, dipeptidyl-peptidase-like protein-6 (DPPX), glycine receptor (GlyR), glutamic acid decarboxylase 65 (GAD65), dipeptidyl-peptidase-like protein-6 (DPPX), IgLON5 et al. 2 The clinical manifestations, severity, and prognosis with specific antibodies are different, but in general, early detection and early treatment are the principles to handle this disease. However, it has to be admitted that there are still difficulties in the early diagnosis of autoimmune encephalitis, although we have made improvements and revision in the diagnostic criteria based on the clinical criteria defined by Graus et al. 3 in 2016 to avoid excessive reliance on the detection of autoimmune antibodies from serum or cerebrospinal fluid (CSF). The problems focus on the heterogeneity of clinical manifestations, low positive rate of imaging evidence, and lack of specificity of EEG. For example, autoimmune encephalitis may involve
“…2, Abb. 3) [47,48,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80]. Dabei kann sowohl ein Hyper-, seltener auch ein Hypometabolismus mesiotemporal auftreten [76,77,81].…”
Bei der limbischen Enzephalitis liefert die zerebrale FDG-PET essenzielle Informationen zur Unterstützung von Diagnose, Prognose und Therapiekontrolle. Mit zunehmender Bedeutung der limbischen Enzephalitis als „not to miss“-Diagnose wird der Stellenwert der zerebralen FDG-PET bei dieser Fragestellung weiter steigen. Zudem kommt der FDG-PET-Ganzkörperaufnahme bei Verdacht auf eine paraneoplastische Genese und unauffälligem Tumorscreening in den Routineuntersuchungen eine Schlüsselrolle zu.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.