Non-paraneoplastic limbic encephalitis characterized by mesio-temporal seizures and extratemporal lesions: a case report

Seizure. 2010 Sep;19(7):446-9. doi: 10.1016/j.seizure.2010.06.002. Epub 2010 Jul 2.


Limbic encephalitis (LE) can be either paraneoplastic or a non-paraneoplastic autoimmune disorder. Magnetic resonance imaging (MRI) of the brain on T2-weighted fluid-attenuated inversion recovery (FLAIR) classically shows hyperintensities of the temporal structures, but multifocal involvement of extratemporal cortex has also been described in paraneoplastic LE. Here we describe a 27-year-old woman whose idiopathic autoimmune (glutamic acid decarboxylase-antibody positive) LE debuted with multiple daily mesio-temporal seizures, amnesia and multifocal extratemporal cortical MRI abnormalities. Mesio-temporal MRI signal increase was found after 20 days. This case report highlights that early diagnosis of non-paraneoplastic LE may be considered in patients with multiple daily mesio-temporal seizures and amnesia even in the absence of early typical MRI abnormalities.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Autoantibodies / blood
  • Autoantibodies / immunology
  • Autoantigens / immunology
  • Autoimmune Diseases / complications*
  • Autoimmune Diseases / immunology
  • Autoimmune Diseases / pathology*
  • Brain / pathology
  • Encephalitis / complications*
  • Encephalitis / immunology
  • Encephalitis / pathology*
  • Female
  • Glutamate Decarboxylase / immunology
  • Humans
  • Magnetic Resonance Imaging
  • Seizures / etiology*
  • Seizures / immunology
  • Seizures / pathology


  • Autoantibodies
  • Autoantigens
  • Glutamate Decarboxylase