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

Epilepsy Behav. 2010 Apr;17(4):555-7. doi: 10.1016/j.yebeh.2010.01.017. Epub 2010 Feb 16.

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.

Publication types

  • Case Reports

MeSH terms

  • Antibodies / therapeutic use*
  • Electroencephalography / methods
  • Fluorodeoxyglucose F18
  • Humans
  • Limbic Encephalitis / diagnostic imaging
  • Limbic Encephalitis / drug therapy*
  • Limbic Encephalitis / immunology*
  • Male
  • Middle Aged
  • Positron-Emission Tomography / methods
  • Potassium Channels, Voltage-Gated / immunology*

Substances

  • Antibodies
  • Potassium Channels, Voltage-Gated
  • Fluorodeoxyglucose F18