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Review
. 2019 May 13;191(19):E529-E534.
doi: 10.1503/cmaj.181548.

Diagnosing autoimmune limbic encephalitis

Adrian Budhram  1 , Andrew Leung  2 , Michael W Nicolle  2 , Jorge G Burneo  2
Affiliations
Review

Diagnosing autoimmune limbic encephalitis

Adrian Budhram et al. CMAJ. .
No abstract available

PubMed Disclaimer

Conflict of interest statement

Competing interests: Jorge Burneo reports receiving grants from the Rick Berg Legacy Fund, the Ontario Brain Institute and Western University, and other support through the Jack Cowin Chair in Epilepsy Research (a Western University Research Chair), outside the submitted work. No other competing interests were declared.

Figures

Figure 1:
Figure 1:
Brain magnetic resonance imaging in autoimmune limbic encephalitis. On coronal fluid-attenuated inversion recovery (FLAIR) image, bilateral T2-hyperintensity of the medial temporal lobes is seen (A, arrows). (B) Bilateral T2-hyperintensity of the medial temporal lobes is also shown on an axial FLAIR image (arrows). Antibodies targeting contactin-associated protein-like 2 were identified in serum by cell-based assay.
Figure 2:
Figure 2:
Magnetic resonance imaging (MRI) mimics of autoimmune limbic encephalitis. (A, B) Herpes simplex virus encephalitis: On axial T2-weighted image, diffuse T2-hyperintensity of the right anteromedial temporal lobe with swelling is seen (A, arrow). There is also T2-hyperintensity of the right insula (B, arrow) that spares the adjacent basal ganglia (red line demarcating separation). (C, D) Temporal lobe glioma: On axial T2-weighted image, diffuse T2-hyperintensity of the right anteromedial temporal lobe is seen (C, arrow). On follow-up MRI 6 months later, there is heterogenous enhancement with local edema on axial T1-weighted post-gadolinium image, concerning for transformation into high-grade glioma (D, arrow). (E) Status epilepticus: On axial T2-weighted image, there is focal T2-hyperintensity of the medial temporal lobes bilaterally (arrows). (F) Acute ischemic stroke: On axial diffusion–weighted image, there is a diffusion-bright lesion of the left medial temporal lobe within the territory of the left posterior cerebral artery (arrow). There is no extension of the lesion into the more anterior or lateral temporal lobe supplied by the left middle cerebral artery (red line demarcating separation), in keeping with acute infarction restricted to a vascular territory.
See this image and copyright information in PMC

References

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Supplementary concepts