Markoula Sofia, Chatzistefanidis Dimitrios, Konitsiotis Spyridon, Kyritsis Athanassios P
Department of Neurology, University of Ioannina; ; Neurology Clinic, General Hospital of Ioannina, Ioannina, Greece.
Department of Neurology, University of Ioannina;
Clin Pract. 2011 Dec 30;2(1):e7. doi: 10.4081/cp.2012.e7. eCollection 2012 Jan 1.
Limbic encephalitis (LE) is rare, presents with memory impairment, seizures and behavioral disorder. We present a 44-year-old female with an agitation-depressive disorder associated with delusions and hallucinations, admitted to our hospital with the diagnosis of psychosis. A computed tomography (CT) scan of the brain and lumbar puncture on admission were normal. Because of clinical deterioration and addition of seizures in the clinical picture, further workup with serum and repeat cerebrospinal fluid studies, magnetic resonance imaging (MRI), and electroencephalogram disclosed a lesion in the left medial temporal lobe consistent with LE. The patient was treated symptomatically with antidepressive, antipsychotic and anticonvulsant drugs. Aggressive diagnostic tests for the presence of an occult cancer were negative. An 8-year follow up has not revealed a tumor to support a paraneoplasmatic origin of LE. This case, initially diagnosed and treated as psychosis, is a case of non-paraneoplasmatic, non-infective LE, probably caused by an autoimmune mechanism.
边缘性脑炎（LE）较为罕见，表现为记忆障碍、癫痫发作和行为障碍。我们报告一名44岁女性，患有伴有妄想和幻觉的激越-抑郁障碍，因精神病诊断入院。入院时脑部计算机断层扫描（CT）和腰椎穿刺结果正常。由于临床病情恶化且临床表现中出现癫痫发作，进一步进行血清及重复脑脊液检查、磁共振成像（MRI）和脑电图检查，发现左侧颞叶内侧有一处与LE相符的病变。患者接受了抗抑郁药、抗精神病药和抗惊厥药的对症治疗。针对隐匿性癌症的积极诊断检查结果均为阴性。8年的随访未发现支持LE副肿瘤性起源的肿瘤。该病例最初被诊断并当作精神病治疗，是一例非副肿瘤性、非感染性LE，可能由自身免疫机制引起。
