Open AccessNeuropsychological implication in possible antibody-negative limbic encephalitis: a clinical case report
Author(s) -
Viviana Lo Buono,
Lilla Bonanno,
Rosanna Palmeri,
Simona Cammaroto,
Rosa Morabito,
Maria Cristina De Cola,
Edoardo Sessa,
Silvia Marıno,
Placido Bramantı,
Francesco Corallo
Publication year - 2022
Publication title -
journal of international medical research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.421
H-Index - 57
eISSN - 1473-2300
pISSN - 0300-0605
DOI - 10.1177/03000605221078715
Subject(s) - limbic encephalitis , medicine , encephalitis , hyperintensity , amnesia , temporal lobe , neuropsychology , amygdala , neuroscience , hippocampus , pathology , limbic system , psychology , magnetic resonance imaging , immunology , psychiatry , central nervous system , epilepsy , cognition , radiology , virus
Autoimmune limbic encephalitis is an antibody-mediated brain inflammatory process, which typically involves the medial temporal lobe. Diagnosis requires the presence of antineuronal antibodies, but sometimes patients present clinical features of limbic encephalitis despite negative serology. Thus, the diagnosis of antibody-negative limbic encephalitis is difficult to make, and it must often rely largely on exclusion of other causes. This current case report describes a 28-year-old male that presented 2 months after the acute event with radiological changes typical of limbic encephalitis, but with no identifiable antibody and neuropsychological impairment. Antibody responses to neurotropic viruses and antibody-mediated encephalitis were negative in serum and cerebrospinal fluid. Magnetic resonance imaging showed signs of hyperintensity in the hippocampus bilaterally, amygdala and left pulvinar. The neuropsychological evaluation showed a deficit in emotional face recognition and severe autobiographical amnesia. Bilateral damage to the medial temporal lobe and hippocampus, including the amygdala, is associated with alterations in autobiographical memories. The neuropsychological impairment documented in this current case expands the range of clinical features of antibody-negative encephalitis and provides evidence that the memory deficit in this disorder is more extensive than was previously recognized.