Abstract:
INTRODUCTION:Limbic encephalitis (LE) associated with voltage-gated potassium channel-complex antibodies (VGKC-LE) is frequently non-paraneoplastic and associated with marked improvement following corticosteroid therapy. Mesial temporal lobe abnormalities are present in around 80 % of patients. If associated or preceded by faciobrachial dystonic seizures, basal ganglia signal changes may occur. In some patients, blurring of the supratentorial white matter on T2-weighted images (SWMB) may be seen. The purpose of this study was to evaluate the incidence of SWMB and whether it is specific for VGKC-LE. METHODS:Two experienced neuroradiologists independently evaluated signal abnormalities on FLAIR MRI in 79 patients with LE while unaware on the antibody type. RESULTS:SWMB was independently assessed as present in 10 of 36 (28 %) compared to 2 (5 %) of 43 non-VGKC patients (p = 0.009). It was not related to the presence of LGI1 or CASPR2 proteins of VGKC antibodies. MRI showed increased temporomesial FLAIR signal in 22 (61 %) VGKC compared to 14 (33 %) non-VGKC patients (p = 0.013), and extratemporomesial structures were affected in one VGKC (3 %) compared to 11 (26 %) non-VGKC patients (p = 0.005). CONCLUSION:SWMB is a newly described MRI sign rather specific for VGKC-LE.
journal_name
Neuroradiologyjournal_title
Neuroradiologyauthors
Urbach H,Rauer S,Mader I,Paus S,Wagner J,Malter MP,Prüss H,Lewerenz J,Kassubek J,Hegen H,Auer M,Deisenhammer F,Ufer F,Bien CG,Baumgartner Adoi
10.1007/s00234-015-1581-xsubject
Has Abstractpub_date
2015-12-01 00:00:00pages
1203-9issue
12eissn
0028-3940issn
1432-1920pii
10.1007/s00234-015-1581-xjournal_volume
57pub_type
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