Management Team

Limbic encephalitis

Overview

It is a rare neurological disorder, in which an autoimmune inflammation of the brain predominantly affects the limbic area, secondary to infection or cancers. It is acute in onset and causes altered sensorium, behaviour changes, seizures.

  • Cancer
  • Herpes simplex encephalitis
  • Autoimmune disorders

  • Older age
  • Weakened immune system
  • Geographical regions where mosquito- or tick-borne viruses spread easily
  • Season of the year
  • Smoking

  • Headache and irritability
  • Behavioural changes- delusion, hallucinations, agitation, psychosis
  • Acute to subacute memory loss
  • Seizures
  • Common antibodies associated with limbic encephalitis are Anti Hu, Anti-Ma, Anti CRMP5, anti-GAD 65, anti Ampiphysin, Anti- NMDAR, anti VGKC, anti AMPA, Anti Glu antibodies

Neurologist

  • CSF and blood investigations to detect pathogenic antibodies
  • FLAIR and contrast changes on MRI in limbic areas
  • PET scan to check increased metabolism in these areas
  • EEG to check for abnormalities

  • Immunomodulation with corticosteroids, intravenous immunoglobulin, plasmapheresis in acute stage
  • Rituximab, cyclophosphamide for long-term therapy
  • Removal of tumour
  • Supportive management of psychosis and seizures
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