EPA-1369 – Limbic Encephalitis; an Interesting Case

Abstract

Introduction and Background

Limbic encephalitis is an autoimmune inflammation of the brain tissues. This category has been increasingly diagnosed over the last few years. This is important as clinicians in neurology and psychiatry need to raise their awareness about this disease.

This is a case of a 63 years old retired man who was admitted following a three week history of generalized weakness, gait disturbance and flu like symptoms.

During admission he developed nystagmus and agitation and was treated with high potency vitamin B complex and Thiamine on the suspicion of Wernicke's Encephalopathy.

A referral was later made to the liaison psychiatry team as the patient was trying to leave the ward and was verbalizing suicidal thoughts.

A suspicion of limbic encephalitis was considered and anti-neuronal Voltage gated potassium antibodies VGKA were measured. The results came back as significantly positive.

He was treated with high dose of steroids. The patient became less aggressive and agitated with time and was eventually discharged to a nursing home.

Conclusions

Limbic Encephalitis is a potentially treatable cause of encephalopathy that can present in a variety of neuropsychiatric manifestations like psychotic symptoms, agitation, memory and sleep impairment. Early diagnosis and treatment is very important as in many cases the disorder is associated with malignancies.

Recommendations

Further emphasis and research is needed on this topic. There is a tertiary centre at the John Radcliffe Hospital, Oxford, UK that follows up patients from all over the United Kingdom.