Limbic encephalitis – notes for psychiatric clinical practice

Abstract

Introduction Limbic encephalitis is a neuropsychiatric syndrome with an autoimmune basis, treated with. Differential diagnosis with psychotic and mood disorders is thus essential for effective treatment and the best outcome possible. Objectives To systematize up-to-date clinical procedures to identify possible limbic encephalitis cases and conduct proper evaluation and treatment of those cases. Aims To improve differential diagnosis between limbic encephalitis and psychotic and mood disorders, in psychiatric clinical practice. Methods Systematic review. Results Limbic encephalitis presents sub-acutely with convulsions and mood, cognitive and perceptive alterations. EEG, neuroimaging, antibody testing and liquor analysis can be useful in diagnosis, and the later also in treatment response prediction. TPO, NMDA receptor, AMPA receptor, GABA-B receptor and K+ channel antibodies are etiological factors for this neuropsychiatric syndrome. Treatment consists of corticoids, immunoglobulin, plasmapheresis, rituximab, cyclophosphamide, azathioprine, mycophenolate, or the treatment of an underlying tumor. Conclusion Proper diagnosis of limbic encephalitis may prevent disease progression and may improve outcome, according to its etiology.