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A 37-year-old man was hospitalised following
a first time generalised tonic clonic seizure.On
admission the patient presented with mood
and behavioural changes, as well as cognitive
dysfunction including short-term memory
problems. Otherwise, clinical neurological
examination was normal.Previous history was
unrevealing apart from earlier drug abuse.
MRI showed bilateral abnormalities in the
limbic system consistent with limbic encephalitis.
Paraneoplastic aetiology could be
excluded by intensive investigations.
The cerebrospinal fluid (CSF) showed a
slight protein elevation, other parameters
were within normal limits. We found no
evidence for viral or bacterial encephalitis.
The patient’s neuropsychological symptomatology
as well as MRI findings improved
markedly on treatment with steroids and
immunoglobulines.
Limbic encephalitis of non-paraneoplastic
origin is a very rare disorder. It may also
be caused by immunological mechanisms
as in our patient. Prognosis is dependent on
diagnosis early in the course of disease and
immediate initiation of steroid and immunoglobuline
therapy.