Limbic encephalitis: Experience of a moroccan center

Area of Science:

• Neurology
• Immunology
• Infectious Diseases

Background:

• Limbic encephalitis (LE) is a rare neurological disorder characterized by inflammation and degeneration of limbic structures.
• Diagnosis can be challenging, especially in resource-limited settings lacking advanced diagnostic tools like antineuronal antibody testing or HSV-PCR.
• Understanding the specific features of LE in different geographical regions is crucial for improving diagnosis and management.

Purpose of the Study:

• To describe the demographic, clinical, paraclinical, and etiological characteristics of limbic encephalitis (LE) in Moroccan patients.
• To evaluate the medium-term prognosis and outcomes of LE in this population.
• To highlight the diagnostic challenges and etiological spectrum of LE in a North African context.

Main Methods:

• Retrospective analysis of patients diagnosed with limbic encephalitis (LE) at the University Hospital Hassan II of Fez, Morocco, from September 2008 to December 2016.
• Data collected included demographic information, clinical manifestations, neuroimaging findings, laboratory results, identified etiologies, and treatment outcomes.
• Statistical analysis was performed to characterize the patient cohort and disease features.

Main Results:

• The study included 31 patients (22 men, 9 women) aged 14-76 years, with a mean age of 45.8 years.
• Acute symptom onset occurred in 64.5% of cases, with common manifestations including psychiatric disorders (48.4%), memory disorders (45.2%), and epileptic seizures (38.7%).
• Identified etiologies included autoimmune (paraneoplastic, anti-NMDA-R), infectious (HSV, syphilis, tuberculosis), and other causes, with 38.7% of cases remaining idiopathic due to incomplete workup. Complete or partial remission was observed in 45.2% and 45.1% of cases, respectively, with significant sequelae including cognitive impairment and epilepsy.

Conclusions:

• Limbic encephalitis (LE) in Morocco exhibits a wide range of etiologies and predominantly an acute onset of symptoms.
• Despite challenges in diagnosis, a significant proportion of patients experience remission, though neurological sequelae and mortality remain concerns.
• Further research and improved diagnostic capabilities are needed to fully elucidate the spectrum and management of LE in the region.