Pediatric neurology · 2013
Limbic encephalitis in a child: an atypical presentation.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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История · было → стало
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Mahmoud Adel A H, Al Ghamdi Fouad A S, Johnston Michael V
Аннотация
BACKGROUND: Limbic encephalitis is a rare disorder with a generally subacute onset evolving over days to weeks. Patients present with a variable combination of memory loss, seizures, and psychiatric disturbance, and it is not rare for patients to be initially misdiagnosed.
PATIENT: We describe a previously healthy 12-year-old boy who developed his first seizures at 8 years of age. He had a total of eight prolonged focal seizures, each followed by a month of behavioral changes and short-term memory loss. There was no family history of seizures or other neurological disorders, and he had an otherwise unremarkable neonatal and medical history.
RESULTS: Magnetic resonance imaging during each episode of seizures showed alternating unilateral brain hemispheric involvement consistent with limbic encephalitis that was followed by resolution for a total of six times. Despite a negative laboratory evaluation for a large panel of paraneoplastic antibodies, the clinical scenario and exclusion of other possible disorders made recurrent limbic encephalitis the most likely diagnosis.
CONCLUSION: Limbic encephalitis is a rare disorder that is diagnosed primarily on the basis of clinical criteria and is often associated with the presence of a paraneoplastic antibody. However, lack of a positive paraneoplastic antibody in a patient with a triad of seizure, behavioral changes, and short-term memory loss does not exclude the diagnosis. The unique presentation in a seronegative patient may indicate an unrecognized antibody.
PATIENT: We describe a previously healthy 12-year-old boy who developed his first seizures at 8 years of age. He had a total of eight prolonged focal seizures, each followed by a month of behavioral changes and short-term memory loss. There was no family history of seizures or other neurological disorders, and he had an otherwise unremarkable neonatal and medical history.
RESULTS: Magnetic resonance imaging during each episode of seizures showed alternating unilateral brain hemispheric involvement consistent with limbic encephalitis that was followed by resolution for a total of six times. Despite a negative laboratory evaluation for a large panel of paraneoplastic antibodies, the clinical scenario and exclusion of other possible disorders made recurrent limbic encephalitis the most likely diagnosis.
CONCLUSION: Limbic encephalitis is a rare disorder that is diagnosed primarily on the basis of clinical criteria and is often associated with the presence of a paraneoplastic antibody. However, lack of a positive paraneoplastic antibody in a patient with a triad of seizure, behavioral changes, and short-term memory loss does not exclude the diagnosis. The unique presentation in a seronegative patient may indicate an unrecognized antibody.