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Limbic encephalitis presenting with topographical disorientation and amnesia.

K Hirayama1, Y Taguchi, M Sato

  • 1Division of Neuropsychology, Department of Disability Medicine, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan. k-hira@mail.cc.tohoku.asc.jp

Journal of Neurology, Neurosurgery, and Psychiatry
|December 18, 2002
PubMed
Summary

This study reports a case of paraneoplastic limbic encephalitis where topographical disorientation was the primary symptom. This condition, associated with anti-Hu antibodies, affected spatial navigation and memory.

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Area of Science:

  • Neurology
  • Neuroimmunology

Background:

  • Paraneoplastic limbic encephalitis (PLE) is an autoimmune disorder often associated with cancer.
  • Limbic encephalitis can present with diverse neuropsychiatric symptoms, including memory deficits and disorientation.

Observation:

  • A 70-year-old woman presented with severe topographical disorientation, landscape agnosia, and heading disorientation.
  • She also exhibited attentional disturbance and anterograde amnesia, with limited retrograde amnesia.

Findings:

  • Magnetic resonance imaging revealed high signal intensities in bilateral anteromedial temporal lobes and specific right-sided posterior brain regions.
  • Serum analysis confirmed the presence of anti-Hu antibodies, a common marker for paraneoplastic syndromes.

Implications:

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  • This case highlights topographical disorientation as a potential primary manifestation of limbic encephalitis.
  • Early recognition of such specific neurological deficits is crucial for diagnosing and managing underlying paraneoplastic conditions.