title: Limbic encephalitis associated with elevated antithyroid antibodies.
abstract: Immune-mediated limbic encephalitis affects both adults and children. Patients typically present with seizures, memory problems, and imaging changes in the medial temporal lobes. Both paraneoplastic and nonparaneoplastic forms have been described in which the antibody to the voltage-gated potassium channel-complex associated protein, leucine-rich glioma-inactivated 1, is most commonly reported. Elevated antithyroid antibodies have also been reported in a range of neurological syndromes with encephalopathy, such as limbic encephalitis, often collectively termed Hashimoto encephalopathy, a condition whereby corticosteroids responsiveness with a complete recovery is commonly observed. Here we describe 3 children presenting with limbic encephalitis with elevated thyroid antibodies that did not respond to corticosteroids alone and required more aggressive immunotherapy, mirroring the slower treatment response that is more frequently seen in other immune-mediated forms of limbic encephalitis.
authors.affiliation: Children's Neurosciences Center, Evelina Children's Hospital at Guy's and St Thomas' NHS Foundation Trust, King's Health Partners Academic Health Sciences Centre, London, UK Nuffield Department of Clinical Neurosciences, West Wing, John Radcliffe Hospital, University of Oxford, Oxford, UK.
authors.forename: Yael
authors.initials: Y
authors.lastname: Hacohen
authors.affiliation: Department of Paediatrics, Royal Hospital for Sick Children, Edinburgh, UK.
authors.forename: Sonia
authors.initials: S
authors.lastname: Joseph
authors.affiliation: Department of Neurology, Alder Hey Children's NHS Foundation Trust, Eaton Road, Liverpool, UK.
authors.forename: Rachel
authors.initials: R
authors.lastname: Kneen
authors.affiliation: Paediatric Neurology, Royal Hospital for Sick Children, Edinburgh, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Eunson
authors.affiliation: Children's Neurosciences Center, Evelina Children's Hospital at Guy's and St Thomas' NHS Foundation Trust, King's Health Partners Academic Health Sciences Centre, London, UK.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Lin
authors.affiliation: Nuffield Department of Clinical Neurosciences, West Wing, John Radcliffe Hospital, University of Oxford, Oxford, UK.
authors.forename: Angela
authors.initials: A
authors.lastname: Vincent
authors.affiliation: Children's Neurosciences Center, Evelina Children's Hospital at Guy's and St Thomas' NHS Foundation Trust, King's Health Partners Academic Health Sciences Centre, London, UK Nuffield Department of Clinical Neurosciences, West Wing, John Radcliffe Hospital, University of Oxford, Oxford, UK ming.lim@gstt.nhs.uk.
authors.forename: Ming
authors.initials: M
authors.lastname: Lim
mesh_terms: D000293:Adolescent; D001323:Autoantibodies / Q000097:blood* / Q000276:immunology; D001921:Brain / Q000473:pathology; D005260:Female; D006801:Humans; D020363:Limbic Encephalitis / Q000097:blood* / Q000473:pathology; D008297:Male; D013961:Thyroid Gland / Q000276:immunology*
chemical_list: D001323:Autoantibodies
keywords: Hashimoto; autoantibodies; encephalitis; encephalopathy; epilepsy; limbic system