ObjectiveTo make a better understanding of potassium channel-complex autoimmune antibodies associated limbic encephalitis, we studied in details with patients of this autoimmune disease accompanying without tumors. MethodsDiagnosis of 3 patients were confirmed by antibody detection in serum or CSF. All the clinical data, including history, CSF data, cranial MRI, EEG, pelvic ultrasound and treatment strategy, were carefully gathered. Two to eleven months follow-up were carried out. Results3 female adult patients showed common initial manifestation of seizures, and changes of consciousness, mental disorder and cognitive impairment. Hyponatremia was found in one LGI1-Ab+ patient. Cranial MRI showed unilateral or bilateral signal changes with limbic system. Changes of CSF and EEG were nonspecific. All 3 patients became recovery in different levels after two to eleven months. ConclusionsPotassium channel-complex antibodies associated encephalitis may be a common type of limbic encephalitis in adults without tumors. Seizures may be the first sign of the disease. Hyponatremia is one of characteristics of LGI1-Ab+ patient. Patients may have a fairly good short outcome.
ObjectivesPost-encephalitic epilepsy could be of great chance of pharmaco-resistant, even surgery may not achieve seizure free. The aim of this study is to mapping epileptogenic area of pharmaco-resistant post-encephalitic temporal lobe epilepsy, to find whether "temporal plus" epilepsy is the main type and its surgery outcome, based on stereo-EEG(SEEG) study.MethodWe retrospectively studied 15 patients with pharmaco-resistant temporal lobe epilepsy. Scalp EEG, seizure semiology, MRI, FDG-PET, and SEEG were reviewed for all patients. According to epileptogenic area which was analysed by SEEG, 15 patients were divided into 2 groups, temporal lobe epilepsy(TLE) group and temporal plus epilepsy(TPE) group. Clinical characteristics were compared with each group, by t-test or Fisher exact test when data needed.ResultsThere were 8 patients in TLE group, with 6 mesial TLE, 1 lateral TLE, 1 mesial-lateral TLE. And 7 patients in TPE group. Age of seizure onset (P=0.548), duration of epilepsy (P=0.099), age of remote encephalitis (P=0.385), type of semiology (P=0.315) and lateralization of MR lesions (P=1.000), interictal FDG-PET hypometabalism (P=1.000) or intracranial implantation (P=0.619) were of no statistically difference between TLE group and TPE group. Surgery was performed in all patients. Better outcome was obtained in TLE group(5/8 class Ⅰ), and poor was in TPE group(3/7class Ⅰ).ConclusionMesial-TLE and temporal plus epilepsy were common types of pharmaco-resistant post-encephalitic TLE. There was no way to differentiate clinically, except by SEEG. Mesial-TLE had a better outcome after surgery, but temporal plus epilepsy did not.