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.
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Further Readings
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.
Malter MP, Widman G, Galldiks N, et al. Suspected new-onset autoimmune temporal lobe epilepsy with amygdala enlargement. Epilepsia. 2016;57:1485–94.
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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.
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Urbach, H., Meyer, P.T., Jamneala, G. (2018). Autoimmune-Mediated Encephalitis. In: Barkhof, F., Jager, R., Thurnher, M., Rovira Cañellas, A. (eds) Clinical Neuroradiology. Springer, Cham. https://doi.org/10.1007/978-3-319-61423-6_72-1
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DOI: https://doi.org/10.1007/978-3-319-61423-6_72-1
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