CSF findings in patients with voltage gated potassium channel antibody associated limbic encephalitis

J Neurol Sci. 2008 May 15;268(1-2):74-7. doi: 10.1016/j.jns.2007.11.004. Epub 2008 Feb 20.


Recently, a new subtype of limbic encephalitis (LE) has been described, serologically characterized by the presence of antibodies against voltage gated potassium channels (VGKC, to be called VGKC-LE). Only little is known about CSF findings in this new disorder. Here we report the results of 29 lumbar punctures in 17 patients with VGKC-LE. Slight pleocytosis, mainly consisting of lymphocytes and monocytes, and elevated total protein concentrations were present in 41 and 47%, respectively. Intrathecal immunoglobulin (Ig) synthesis as defined by the presence of CSF-specific oligoclonal IgG bands, an increased IgG index, or an elevated IgG, IgA, or IgM ratio, was not detected in any of the patients, but dysfunction of the blood-CSF barrier was found in 35%. CSF findings were normal in 23%.

Conclusions: Unlike paraneoplastic LE, VGKC-LE is not frequently associated with intrathecal Ig production or markedly elevated white cell counts. Thus, normal CSF findings do not preclude the disease. VGKC-Ab should, therefore, be determined whenever LE is clinically suspected, irrespective of the presence or absence of inflammatory CSF changes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Isoelectric Focusing / methods
  • Lactic Acid / cerebrospinal fluid
  • Leukocyte Count / methods
  • Limbic Encephalitis / cerebrospinal fluid*
  • Male
  • Middle Aged
  • Oligoclonal Bands / cerebrospinal fluid*
  • Potassium Channels, Voltage-Gated / immunology*
  • Retrospective Studies


  • Oligoclonal Bands
  • Potassium Channels, Voltage-Gated
  • Lactic Acid