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Two different presentations, one diagnosis

Gavin McCluskey1, Chandni K Rajani2, Gareth Lewis3

  • 1FY1, Altnagelvin Area Hospital.

Acute Medicine
|September 18, 2014
PubMed

Insights

Anti-voltage gated potassium channel (VGKC) antibody limbic encephalitis can present with confusion and seizures. Early immunotherapy significantly improves patient outcomes in these cases.

Area of Science:

  • Neurology
  • Immunology

Background:

  • Acute confusion and hyponatremia are frequent presentations in acute medical settings.
  • Autoimmune encephalitis, particularly anti-VGKC antibody-related limbic encephalitis, presents a diagnostic challenge due to variable clinical manifestations.

Observation:

  • Two cases of anti-VGKC antibody-related limbic encephalitis are presented, showcasing diverse clinical presentations.
  • Standard investigations including MRI, lumbar puncture, EEG, and autoimmune/infectious screens were performed.

Findings:

  • Both patients tested positive for anti-VGKC antibodies.
  • Prompt immunotherapy led to significant clinical recovery in both cases.

Implications:

  • Patients with unexplained confusion and seizures warrant expedited autoimmune encephalitis investigation.
  • Atypical psychiatric presentations, such as drowsiness, should also prompt consideration of autoimmune causes.
  • Early diagnosis and treatment with immunotherapy or steroids improve outcomes for anti-VGKC antibody-related limbic encephalitis.

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