Limbic Encephalitis and Refractory Status Epilepticus in the ICU: Classification, Diagnosis and Treatment

Abstract

Limbic encephalitis is a rare auto-immune condition that usually presents subacutely with vague symptoms such as headache, confusion and memory loss.1 If not diagnosed early the sequelae can be severe, including refractory status epilepticus. The majority of cases are associated with underlying neoplasia. We present a case of voltage-gated potassium channel limbic encephalitis and its subsequent management during a long ICU admission. We discuss the classification, diagnosis and treatment of limbic encephalitis, review the use of sodium thiopental to achieve burst suppression in refractory status epilepticus, and the use of continuous EEG monitoring in the ICU.