Improvement of non-paraneoplastic voltage-gated potassium channel antibody-associated limbic encephalitis without immunosuppressive therapy

Abstract We describe a 61-year-old patient with clinical evidence of limbic encephalitis who improved with anticonvulsant treatment only, that is, without the use of immunosuppressive agents. Three years following occurrence of anosmia, increasing memory deficits, and emotional disturbances, he pres...

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Bibliographic Details
Published in:Epilepsy & behavior 2010-04, Vol.17 (4), p.555-557
Main Authors: Gast, Heidemarie, Schindler, Kaspar, Z’Graggen, Werner J, Hess, Christian W
Format: Article
Language:English
Subjects:
Antibodies - therapeutic use
Anticonvulsant treatment
Electroencephalography - methods
Fluorodeoxyglucose F18
Humans
Immunosuppression
Limbic Encephalitis - diagnostic imaging
Limbic Encephalitis - drug therapy
Limbic Encephalitis - immunology
Male
Middle Aged
Neurology
Positron-Emission Tomography - methods
Potassium Channels, Voltage-Gated - immunology
Temporal lobe epilepsy
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Summary:Abstract We describe a 61-year-old patient with clinical evidence of limbic encephalitis who improved with anticonvulsant treatment only, that is, without the use of immunosuppressive agents. Three years following occurrence of anosmia, increasing memory deficits, and emotional disturbances, he presented with new-onset temporal lobe epilepsy, with antibodies binding to neuronal voltage-gated potassium channels and bitemporal hypometabolism on FDG-PET scan; the MRI scan was normal. This is most likely a case of spontaneous remission, illustrating that immunosuppressive therapy might be suspended in milder courses of limbic encephalitis. It remains open whether treatment with anticonvulsant drugs played an additional beneficiary role through the direct suppression of seizures or, additionally, through indirect immunomodulatory side effects.
ISSN:1525-5050
1525-5069
DOI:10.1016/j.yebeh.2010.01.017