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Striatal hypermetabolism in limbic encephalitis.

Caroline Rey¹, Lejla Koric, Eric Guedj

¹Pôle de Neurosciences Cliniques, CHU Timone, Marseille, France.

Journal of Neurology

|November 15, 2011

Summary

Striatal hypermetabolism on 18FDG-PET scans may indicate limbic encephalitis associated with anti-neuropil antibodies. This finding aids in diagnosing and monitoring this treatable autoimmune neurological disorder.

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Area of Science:

Neurology
Neuroradiology
Immunology

Background:

Striatal hypermetabolism on 18FDG-PET scans is associated with autoimmune disorders.
Previous associations include Sydenham chorea, lupus, and antiphospholipid syndrome.

Observation:

Three patients with non-paraneoplastic limbic encephalitis presented with 18FDG-PET hypermetabolism in both striata.
This contrasted with diffuse hypometabolism in other brain regions.
All patients exhibited subacute dementia and antibodies to voltage-gated potassium channels.

Findings:

Striatal hypermetabolism on 18FDG-PET can be indicative of limbic encephalitis linked to anti-neuropil antibodies.
Neurological status and brain metabolism improved with immunosuppressive therapy.

Implications:

18FDG-PET striatal hypermetabolism may serve as a diagnostic marker for limbic encephalitis.
This finding aids in identifying a rare, treatable autoimmune neurological condition.
It may also function as a prognostic indicator for disease outcome.