Clinical analysis and comparison of three patients with limbic encephalitis of different kinds of antibodies against neuronal cell surface

Abstract

Objective To analyze and compare the clinical features of three patients with limbic encephalitis of different kinds of antibodies against neuronal cell surface. Methods The clinical data of three patients with limbic encephalitis, including one with anti-N-methyl-D-aspartate(NMDA)receptor encephalitis, one with anti-leucine-rich glioma-inactivated 1(LGI1)antibody and one with anti-gamma-aminobutyric acid B(GABAB)receptor antibody; their clinical manifestations, outcomes, assistant examination results, therapies and prognoses were listed, analyzed and compared. Results All 3 patients presented cognitive impairment, psychiatric symptoms, seizures, abnormal movements and increased T2-weighted imaging or fluid-attenuated inversion-recovery signal on MR imaging; however, mediated by different antibodies, each patient possessed specific features. The young girl with anti-NMDA receptor encephalitis presented oro-facial dyskinesias, hypersalivation and hypoventilation, and had to get tracheotomy and mechanical ventilation, and ovarian teratoma was found through CT. The patient with anti-LGI1 antibodies manifested like faciobrachial dystonic seizure. The patient with anti-GABAB receptor antibody got the disease after nephrectomy due to renal clear cell carcinoma. With or without tumor, all the three patients responded well to immunotherapy. Conclusion Different kinds of limbic encephalitis with different antibody against neuronal cell surface have different clinical features, whereas, all of them are sensitive to immunotherapy. Key words: Limbic encephalitis; Antibodies against neuronal cell surface; N-methyl-D-aspartate receptor encephalitis; Leucine-rich glioma-inactivated 1 antibody; Gamma-aminobutyric acid B receptor antibody