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Autoimmune-Mediated Encephalitis

  • H. Urbach
  • P. T. Meyer
  • G. Jamneala
Living reference work entry

Abstract

Autoimmune-mediated encephalitis (AE) is considered an under-recognized disease with many neurological syndromes and specific antibodies described in the past 10 years. Clinical neuroradiology, using different radiological and nuclear medicine techniques such as MRI and FDG-PET, plays a crucial role in suggesting the diagnosis of AE. Bilateral medial temporal lobe T2 hyperintensities are a diagnostic core feature in autoimmune limbic encephalitis and typically predate antibody detection. Specific antibodies are targeted against intracellular or neuronal surface antigens and suggest a either paraneoplastic or non-paraneoplastic origin. MRI is abnormal in around 70% of patients with autoimmune limbic encephalitis and has a lower sensitivity than FDG-PET. The main indication to perform MRI remains the exclusion of a broad list of differential diagnoses.

Keywords

MRI Autoimmune encephalitis Limbic encephalitis Amygdala VGKC NMDAR Onconeural 

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Further Readings

  1. da Rocha AJ, Nunes RH, Maia AC Jr, do Amaral LL. Recognizing autoimmune-mediated encephalitis in the differential diagnosis of limbic disorders. AJNR Am J Neuroradiol. 2015;36:2196–205.CrossRefPubMedGoogle Scholar
  2. Malter MP, Widman G, Galldiks N, et al. Suspected new-onset autoimmune temporal lobe epilepsy with amygdala enlargement. Epilepsia. 2016;57:1485–94.CrossRefPubMedGoogle Scholar
  3. Urbach H, Mast H, Egger K, Mader I. Presurgical MR imaging in epilepsy. Clin Neuroradiol. 2015b;25(Suppl 2):151–5.CrossRefPubMedGoogle Scholar
  4. Urbach H, Rauer S, Mader I, et al. Supratentorial white matter blurring associated with voltage-gated potassium channel-complex limbic encephalitis. Neuroradiology. 2015a;57:1203–9.CrossRefPubMedGoogle Scholar
  5. Vincent A, Buckley C, Schott JM, et al. Potassium channel antibody-associated encephalopathy: a potentially immunotherapy-responsive form of limbic encephalitis. Brain. 2004;127:701–12.CrossRefPubMedGoogle Scholar
  6. Wagner J, Schoene-Bake JC, Malter MP, et al. Quantitative FLAIR analysis indicates predominant affection of the amygdala in antibody-associated limbic encephalitis. Epilepsia. 2013;54:1679–87.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Department of Neuroradiology, Faculty of MedicineMedical Center – University of FreiburgFreiburgGermany
  2. 2.Department of Nuclear Medicine, Faculty of MedicineMedical Center – University of FreiburgFreiburgGermany

Section editors and affiliations

  • Alex Rovira
    • 1
  1. 1.University Hospital Vall d’HebronBarcelonaSpain

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