A Case Report of Seronegative Limbic Encephalitis

Munawar, Maham; Iftikhar, Pulwasha M; Khan, Jehanzeb; Syed, Nadir Ali; Syed, Taimur A

doi:10.7759/cureus.4681

Cited by 3 publications

(3 citation statements)

References 13 publications

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“…Of note, the seizures accompanying LE can be refractory to a wide variety of anti-epileptic drugs as in our case due to the origin of the seizures being in the medio-temporal lobe, which was the trigger for the extensive evaluation that was pursued in our case after having resistant severe seizures and an EEG concerning for temporal lobe seizures [5].…”

Section: Discussionmentioning

confidence: 86%

Limbic Encephalitis as a Presenting Complication for Small Cell Lung Cancer

Abu-Hashyeh¹,

Katabi²,

Zeid³

2020

Cureus

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Limbic encephalitis (LE) is a rare neurological paraneoplastic complication that occurs secondary to malignant tumors. It is commonly presented as refractory seizures that are resistant to most anti-epileptics. We are presenting a unique case of small cell lung cancer complicated with LE. The challenging part of our case is that the patient had a history of seizure disorder in the past, and she was treated initially as an anti-epileptic treatment failure. A 68-year-old patient with a history of epilepsy was admitted to the ICU with resistant status epilepticus (SE), and respiratory failure secondary to pneumonia. Further workup revealed that the patient has small cell lung carcinoma. An extensive workup done to investigate resistant seizures revealed that she had a rare type of paraneoplastic autoantibodies (Anti-Hu) in the cerebrospinal fluid, which supported the diagnosis of the paraneoplastic autoimmune LE. High dose steroids helped to decrease the seizures episodes, but the family decided to proceed with palliative measures only at the end. Diagnosing LE requires ruling out other common causes of SE. Treatment options include treating underlying cancer as well as means of immunosuppression or antibody removal by tacrolimus and cyclophosphamide and even intravenous immunoglobulin (IVIG) or plasma exchange. It is important to consider LE in the differential diagnosis when managing patients with resistant SE in the ICU, even if the brain imaging and cerebrospinal fluid (CSF) analysis were within normal limits.

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Section: Discussionmentioning

confidence: 86%

Limbic Encephalitis as a Presenting Complication for Small Cell Lung Cancer

Abu-Hashyeh¹,

Katabi²,

Zeid³

2020

Cureus

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“…The association with malignancy was later acknowledged in 1968 5 . Subsequent cases have characterised limbic encephalitis as a rapid onset of cognitive impairment with neuropsychiatric features and refractory seizures 1–3,6 . The pathogenesis of LE has been broadly categorised into three main disease processes: infectious, paraneoplastic and autoimmune (AE) 3,7 .…”

Section: Discussionmentioning

confidence: 99%

Seronegative autoimmune limbic encephalitis with psychiatric symptoms

Asgari

Mbizvo

Smith

et al. 2022

Prog Neurol Psychiatry

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Seronegative autoimmune limbic encephalitis is a rare clinical syndrome defined by a rapid onset of cognitive impairment with neuropsychiatric features and an absence of associated autoantibodies that often lead to diagnostic uncertainty, delayed treatment and ultimately, poor prognosis. Here a case is presented that highlights the benefits of implementing a multidisciplinary approach to treating the psychiatric manifestations, including a cautious use of therapeutic home leave for patients where the clinical course is prolonged.

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“…This disease generally has two causes: paraneoplastic and autoimmune. The paraneoplastic form is associated with certain tumors, including small cell lung cancer (SCLC), germ cell testicular tumor, breast cancer, Hodgkin's lymphoma, immature teratoma, and thymoma [4].…”

Section: Introductionmentioning

confidence: 99%

Post-COVID-19 Vaccine Limbic Encephalitis: A Case Report

Albsheer¹,

Fadul²,

Abdalla³

et al. 2022

Cureus

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Limbic encephalitis (LE) diagnosis can be challenging due to its broad spectrum of clinical presentation and variety of causes. The most commonly known causes include paraneoplastic and autoimmune, but they can also occur post-vaccine. Since 2020, many people worldwide have received the coronavirus disease 2019 (COVID-19) vaccine after FDA approval. Mild self-limited neurological adverse reactions, including headache and dizziness, were reported post-vaccine. However, emerging few neurological severe events, including encephalitis, have also been reported. Herein, we present a case of a middle-aged female who presented with seizures after two days of receiving the second dose of the Moderna COVID-19 vaccine. A diagnosis of limbic encephalitis was made based on head MRI findings. It was treated with immunosuppressive agents and responded well with no additional neurological sequelae. This case is unique as it highlights a possible association between limbic encephalitis and the COVID-19 vaccine.

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A Case Report of Seronegative Limbic Encephalitis

Cited by 3 publications

References 13 publications

Limbic Encephalitis as a Presenting Complication for Small Cell Lung Cancer

Limbic Encephalitis as a Presenting Complication for Small Cell Lung Cancer

Seronegative autoimmune limbic encephalitis with psychiatric symptoms

Post-COVID-19 Vaccine Limbic Encephalitis: A Case Report

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