Recurrent Anti-AMPA Receptor Limbic Encephalitis: A Case Report and Literature Review

Area of Science:

• Neuroimmunology
• Neurology

Background:

• Autoimmune encephalitis targeting neuronal surface antigens, such as Alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptors, represents a significant neurological challenge.
• Limbic encephalitis (LE) associated with anti-AMPA receptor antibodies is relatively rare, often presenting with complex neurological symptoms.

Observation:

• A case study details a 47-year-old Chinese man with anti-AMPA receptor limbic encephalitis, initially showing cognitive decline, undetectable antibodies, and normal MRI.
• The patient later developed typical autoimmune limbic encephalitis with multiple relapses and exhibited progressive brain atrophy, a rare manifestation.

Findings:

• The study reviewed nine reported cases of relapsing anti-AMPA receptor limbic encephalitis, alongside the presented case.
• Progressive brain atrophy was identified as a rare but notable feature in this form of autoimmune encephalitis.

Implications:

• Autoimmune limbic encephalitis should be considered in differential diagnoses for patients with suggestive symptoms, even with normal initial MRI and antibody tests.
• Increased clinical vigilance for relapses in anti-AMPA receptor encephalitis is crucial for timely diagnosis and management.