Striatal hypermetabolism in limbic encephalitis.

Caroline Rey, Lejla Koric, Eric Guedj, Olivier Felician, Elsa Kaphan, José Boucraut, Mathieu Ceccaldi

Pôle de Neurosciences Cliniques, CHU Timone, Marseille, France.

Journal of neurology 2012 Jun

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Striatal hypermetabolism on 18FDG-PET scan is a neuroradiological finding that has been described in association with autoimmune disorders such as Sydenham chorea, lupus or antiphospholipid syndrome. Here, we report three patients with non-paraneoplastic limbic encephalitis characterized by 18FDG-PET hypermetabolism of both striata, in contrast with diffuse hypometabolism in the rest of the brain. All patients developed subacute dementia, and antibodies to voltage-gated potassium channels were found in all cases. Brain metabolism and neurological status improved within a few months of immunosuppressive therapy. The finding of striatal hypermetabolism on 18FDG-PET images could thus be highly indicative of limbic encephalitis associated with anti-neuropil antibodies. It could be of significant help in the diagnosis of this rare and treatable condition, and may also provide a useful marker of disease outcome.

Citation

Caroline Rey, Lejla Koric, Eric Guedj, Olivier Felician, Elsa Kaphan, José Boucraut, Mathieu Ceccaldi. Striatal hypermetabolism in limbic encephalitis. Journal of neurology. 2012 Jun;259(6):1106-10