Emilija Šlajūtė¹, Greta Pšemeneckienė^1,2

¹Lithuanian University of Health Sciences, Faculty of Medicine, Kaunas, Lithuania

²Hospital of Lithuanian University of Health Sciences Kauno Klinikos, Department of Neurology, Kaunas, Lithuania

Abstract

Background. Autoimmune limbic encephalitis is an antibody-mediated inflammatory disease affecting the CNS, characterized by short-term memory impairment, epileptic seizures, and psychiatric symptoms—manifestations common to a broad spectrum of diseases. Despite established diagnostic criteria, the differential diagnosis of limbic encephalitis is challenging.

Case report. A 41-year-old woman, previously experiencing a fever, developed an epileptic seizure, followed by impaired consciousness, behavior, and memory. Blood, urine, and CSF analysis revealed no significant changes. COVID-19 infection, chronic CNS infections, and psychoactive substance use were excluded. Brain MRI suggested limbic encephalitis, prompting an Autoimmune Encephalitis Panel evaluation. Given the history of alcohol abuse, Wernicke’s encephalopathy remained a consideration, leading to the treatment with thiamine and antipsychotics. All symptoms except memory impairment resolved. Further assessment for persistent memory issues identified neuropsychological and radiological uncus pathology features. Subsequent analyses of CSF and the CSF Autoimmune Encephalitis Panel showed no abnormalities. However, Anti-Yo and Anti-Recoverin onconeuronal antibodies, which were not specific to the patient’s condition, were identified in the blood serum in the absence of oncology. After the exclusion of other causes, limbic encephalitis was set as the most likely diagnosis, which resulted in the administration of methylprednisolone and cognitive function restoration.

Conclusions. The presence of overlapping symptoms in limbic encephalitis and the identification of numerous potential causes of condition complicate its differential diagnosis. It is essential to approach the assessment of the patient’s comorbidities and lifestyle factors with caution, recognizing that they may not directly cause the observed condition.

Keywords: autoimmune encephalitis, paraneoplastic syndromes, anti-Yo antibodies, Wernicke encephalopathy.

Full article

https://doi.org/10.53453/ms.2024.5.12

Exploring the diagnostic challenges of autoimmune encephalitis:

the impact of lifestyle factors on clinical assesment

Emilija Šlajūtė

1

, Greta Pšemeneckienė

1,2

1

Lithuanian University of Health Sciences, Faculty of Medicine, Kaunas, Lithuania

2

Hospital of Lithuanian University of Health Sciences Kauno Klinikos, Department of Neurology, Kaunas,

Lithuania

Abstract

Background.   

                    





Case report. !"#""!

"$%"

&'( )"!#$

*+(,-"."

/01!

       #      " %     

2

%%,-!3!"4

+"!!1!

#!

 0    !            " 



Conclusions. 5"

(

1!

"

Keywords:4/0

Journal of Medical Sciences. 5 May, 2024 - Volume 12 | Issue 3. Electronic - ISSN: 2345-0592

Medical Sciences 2024 Vol. 12 (3), p. 112-117, https://doi.org/10.53453/ms.2024.5.12

112

Autoimuninių encefalitų diagnostikos iššūkiai: gyvensenos

veiksnių įtaka klinikiniam įvertinimui

Emilija Šlajūtė

1

, Greta Pšemeneckienė

1,2

,

1

Lietuvos sveikatos mokslų universitetas, Medicinos fakultetasKaunas, Lietuva

2

Lietuvos sveikatos mokslų universiteto ligoninė Kauno klinikos, Neurologijos skyrius, Kaunas, Lietuva

Santrauka

Įvadas.067889"7:9

06090800;0

60779:08<"

90<<60

Klinikinis atvejis.  : 0<=" >"08  0

<"9?90@8<0"0<70=7

"  -0"787  :7  "8  &'( )  08   99    08  "

000"7*+5>77

067  9  9    0  "8  9  "      /0

8990-9

609 98  =<0  00  <?9<0  0 "

860=A0":707

  7  067    @8      9  60  <0  4    

+"06=000 :

0000""

Išvados.   0  609        00  :    0  7

:7"079?B0?"<0?"

8""0<0"609:

Raktažodžiai:         4  06  /0

8

Journal of Medical Sciences. 5 May, 2024 - Volume 12 | Issue 3. Electronic - ISSN: 2345-0592

113

1. Įvadas

    C,D    7

:9    0?    7

067  0    0  <

7    ?   -

<=

98 . :>    

"87  0=7    9  9

9    " =  0  7

067<00"08 

ACA,D"<

  7 @09  A,  <<0  

09    0  8

$97

:7  A,    6    0

70606099

:90<<60

 

0"  A,  9    "0>  ?

0  :0      <  

8  7  :>      <

0"  08  A,  0  

08  "6  06  8B  

      

06  <  7  "<    

80770A,

9    <7  067      9

>  0B  ?    <0

00: 

E  8    9  

90"8>

2. Klinikinis atvejis

    :    >"0  7

707  07      0

0  9      8

809"B

090<="@8

  0  8    0  09

7?0@0<7

07 A0"  9  "  CF G

H

?7ID      00    CGJ

ID@8  0 98B(* 

(.<"?&'( )08

99    08  C9  3'

08  0        0

9  8D  "  00

007    0  0  

0"787  :7  "8?  "

    0"7

087  >"  68    88

0."7

88 C*+5D  0000

  06    0  

:5K/: 8

080=7/(I:*:

<0<:09

  009  0  L  A,  "  

7706790

<  9  0      "0

  A0  067    7

099<<08

9  0?  7    "8  0>

    /0  8

9      "9

8  9  9  

-9

609  98  8  

08=<00"

9  9  <  >    B  '9

B$9"

0?08=

-097909>?9

<0    0  0  >"

0"  08  "  0  -9

609      C  *  *  

,#  **,D      

0"  0  C**,  ; KH  D

(<9    <  "

  0  A0"  :7  0=7

Journal of Medical Sciences. 5 May, 2024 - Volume 12 | Issue 3. Electronic - ISSN: 2345-0592

114

"  @8    0    4

C- D06:00

0898

0  6<  08  :98

-08  "  7  *+5  098  

8088    0    :

5K/  :  C  "D  7  :  /0

8  B  00  9

0  $  9  "7  0  L

B  8?  "

0  0  0?  909

>""7*+508

1 paveikslas. Galvos smegenų MRT kairėje medialiai smilkininėje skiltyje (uncus projekcijoje) hiperintensinis

židinys T2W režime.

-



97"7*+5098<0

0      0

  09    :7  "

0  <9>  >  >"?

    9  

09098<8

8"<

;  :  <0    8  

7 7  067  9  0""

  $68  08

C,,.D0985&8:0

6  0<9  9  9

    7    *  ,,.

0    9  0  (<0

89  9      9

B  B  9  

<00?079609

0908J007

7  067  ? 4  067

  08    "  "

-0>  0?  08      

4067+"067

0

0: 9 609

>"0"8

0      0  

090""

3. Diskusija

8

80=

  06  A,  :  

06  <  7  "<  

C*+  A.(   -+K  .$$D  

06  <    8  

    

C.3*K?+*-MD=

06  <    8  

    

09    0  KM)GNO  "87

= 06  <  7  "<

  ;  GHGNO "87    06

Journal of Medical Sciences. 5 May, 2024 - Volume 12 | Issue 3. Electronic - ISSN: 2345-0592

115

A,080"

A0"      8  *

06      ;  06  <

  8    

A.( 06

  -9    0  4    

+"0600067<

  8    

      >  9

6  A,  4  06  :  

0      0  B

978?0670<:7

"0=40609

        )GNO  "87 

+"  06  0    8  

0?  =7    067  "9:  0

8? 

      6

6  <0=    

  0  009  <<0  ,

      <  :7    ?

"99

  0  8  

?9  0  <0    

0  P:?B007

7  <0      A,

  0  9  0 99

08  "  0   KG ) 

08  0"8  88    0

J  < MG  CHQNOD  7  =7 A,

99"08"9

097877<00A,

9";Q9 0

,  8    07  7  "  >"

70

60  0  09    07  

 709  0

6 60  C"R 8?D

>  ?      698

0=      

 5    "  0<0  "  0

<0?BB<"0

  "      609  :  ,

9  0  <<60    :

:"0>"8

60B  "00 : 0

"<"07 

A,  8  8    0  "

0.08R DJ9

8069

:SKD*+55K/I%A(+

70=70SJD0"

9  C07  T  MF G

H

ID   ,,.  

9770"9

0S  D    0  : U  "

7  *+5  5K/    

:    0  "8  7  08  0

0="0A,8

06 *679"7

*+59"A,60

7 067  0  U 0"  7

  "  6  :9  09

8 50  "8 A,   

0"900

98  :    0    07

067 0  A,    < 9

0  "7  .  7  087  A,

    0    8

0<0<0=9

:?

4. Išvados

  0  609    

  00  :    0  7

:7  "07      9?

B0?"<0?

"    8    "

"0<0"

609:



Journal of Medical Sciences. 5 May, 2024 - Volume 12 | Issue 3. Electronic - ISSN: 2345-0592

116

Literatūros šaltiniai

  $  5  A!  U    

!

%KG )S GRQG

K    -0  U  @  + *@  

A    A  '    

        



KG QSQJC DR HH;VV

JU$U3@*

A  ,R    +"!  

%

KGK S JCQD

,*/."53,

$*$P



*CADKGKGSKGCDRJQ);)K

M3@450@@

@  &    30!  3      -

A,!

A5++

&KG )S KCKDRHH;VK

H$A*/$U.

      

*UKG )S ) C )DS,MK);J

V  $0    P    3  U  (  +

-R

          -

KGKKSKKC DR );J 

Q    3  -  U  (      $

$"+$!*

R  -    

        

  U      -

KGK S)KCVDRVMV;HQ

)  '    .  .A        ,

*   $      , 

    R  

UKGKGSKHVC DRKH;

JM

G.%'*W

U.    '          P

-



KGK SQCDR G 

    /  /0  @

'  @      3  5

    "    

VV

$*KG )S )C D

K  $    +    3  5

A%  P  %  3  3   

          !

    U  

KG )SKHHC DR K;JK

J  %  ,-  .!  *  A

$0@*5$0

      ,  *  

U*KGKJSQGC DRJG;)

$ A*/ $

U.        

*UKG )S ) C )DR,MK);J

M.%5*U$+$$

.    5            

        A

KG HS MCDRJ)

Journal of Medical Sciences. 5 May, 2024 - Volume 12 | Issue 3. Electronic - ISSN: 2345-0592

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