FDG-PET and MRI in potassium channel antibody-associated non-paraneoplastic limbic encephalitis: correlation with clinical course and neuropsychology.
OBJECTIVE
We report a patient with potassium channel antibody-associated non-paraneoplastic limbic encephalitis (NPLE) in whom repeated fluorodeoxyglucose-positron emission tomography (FDG-PET) and magnetic resonance imaging (MRI) are correlated with epileptic activity and memory performance during the course of disease.


METHODS
A 32-year-old woman suffered from prolonged global amnesia after two generalized tonic-clonic seizures due to NPLE. Initially, MRI showed swelling of the left hippocampus. In FDG-PET, however, bitemporomesial hypermetabolism was seen corresponding to frequent bitemporal independent seizure patterns. Also neuropsychological impairments pointed to a bitemporal involvement at this early stage. In parallel with improved control of electrographic seizure patterns, improvement was seen in FDG-PET and in memory performance. During the whole course, MRI showed only left-sided abnormalities, which correlated with a permanent verbal memory impairment.


CONCLUSIONS
FDG-PET was more sensitive in showing the initial bitemporal involvement and correlated well with EEG findings and neuropsychological impairment in the acute phase of disease. In contrast, structural MRI better reflected persistent neuropsychological deficits.
Fauser
S
S
Epilepsy Center, University of Freiburg, Freiburg, Germany. fauser@nz11.ukl.uni-freiburg.de
Talazko
J
J
Wagner
K
K
Ziyeh
S
S
Jarius
S
S
Vincent
A
A
Schulze-Bonhage
A
A
D000328:Adult; D000647:Amnesia / Q000209:etiology; D005260:Female; D019788:Fluorodeoxyglucose F18; D007839:Functional Laterality; D006801:Humans; D020363:Limbic Encephalitis / Q000150:complications / Q000000981:diagnostic imaging* / Q000276:immunology*; D008279:Magnetic Resonance Imaging; D049268:Positron-Emission Tomography; D015221:Potassium Channels / Q000276:immunology*; D011379:Prognosis; D011859:Radiography; D019275:Radiopharmaceuticals; D012640:Seizures / Q000209:etiology; D012680:Sensitivity and Specificity; D013702:Temporal Lobe / Q000473:pathology
D015221:Potassium Channels; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18