What is Limbic Encephalitis?

Limbic encephalitis causes inflammation of the brain which is caused due to an abnormal state in which antibodies start to conflict each other. This state is called as autoimmunity. It can also lead to cancer in some cases. Limbic encephalitis mostly affects more than just the limbic system of the brain as revealed in many of the post-mortem studies.

Most of the cases of the limbic encephalitis are caused due to tumor in the brain that may or may not be diagnosed. In such cases, complete removal of tumor is the only solution. However, it may not be always possible. The auto-antibody leading to limbic encephalitis differentiates one type from another.

What is Limbic Encephalitis?

Some of the common types of anti-bodies which can lead to limbic encephalitis are:

  • Anti-Hu, which usually leads to small-cell carcinoma of the lungs.
  • Anti-Ma2, which leads to germ-cell tumors of the testis.
  • Anti-NMDAR, which will lead to tumors in the ovaries known as teratomas.

This article will be helpful for the people suffering with limbic encephalitis and their families in gaining in-depth knowledge of limbic Encephalitis. Limbic system is vital part of the brain that is responsible for memory, learning and controlling emotions such as anger, love, sexual desire, jealousy and love. Limbic system can be segmented into four parts including thalamus, hippocampus, amygdala and hypothalamus. When the limbic area and its surrounding is inflamed (swollen) or stops functioning, it is regarded as limbic encephalitis or LE. Common symptoms of limbic encephalitis include loss of memory, confusion, seizures, difficulty in sleeping and psychological disturbances like personality disorder.

Types of Limbic Encephalitis

Majority of the cases of limbic encephalitis fall can be grouped into 2 types:

  • Infectious limbic encephalitis: It occurs when the limbic area is attacked by virus or some other bug.
  • Autoimmune limbic encephalitis: It is caused in a state where immune system of a person starts to react to some components of the limbic area as antibody.

Causes of Limbic Encephalitis

Infectious Causes of Limbic Encephalitis: Inflammation in the limbic area can be caused by infection in the brain or due to some viruses like herpes simplex virus (HSV). Thus diagnoses of “Limbic Encephalitis” and “Herpes Simplex Encephalitis” refer to a similar condition.

Autoimmune Causes of Limbic Encephalitis: Under normal condition immune system fights against the infections but in case of autoimmune disease, it starts to produce antibodies against proteins of our own body. When these proteins are associated with the proteins of the limbic area of the brain, it is termed as “Autoimmune Limbic Encephalitis”

Autoimmune Limbic Encephalitis can be further classified into following two categories: Paraneoplastic Limbic Encephalitis (PLE) and Non-paraneoplastic Limbic Encephalitis (NPLE).

  1. Paraneoplastic Limbic Encephalitis (PLE): Researchers are still trying to determine what causes immune system to react against limbic area in the brain but in some cases it can result due to cancer. This situation is referred as “Paraneoplastic” Limbic Encephalitis. In an individual suffering from PLE or Paraneoplastic Limbic Encephalitis, there is high probability of cancer of the thymus gland, lung, testis or breast caused by PLE. It can be diagnosed by looking for the presence of one of a group of paraneoplastic auto-antibodies in the blood. By treating blood cancer, PLE or Paraneoplastic Limbic Encephalitis can be stabilized in most cases and in case of permanent damage to cells of brain, it may not work.
  2. Non-Paraneoplastic Limbic Encephalitis (NPLE): Fewer cases of NPLE have been reported in the last few years. Thus while diagnosing for any type of limbic encephalitis; doctors first look for symptoms of paraneoplastic limbic encephalitis by looking for presence of paraneoplastic antibodies in blood. This situation can be treated by use of drugs like intravenous immunoglobulins, steroids and plasma exchange that can help in suppressing immune system. These drugs include steroids. Most of the cases have revealed that NPLE or Non-Paraneoplastic Limbic Encephalitis is caused when some antibodies start to fight against tissues of the brain especially parts of limbic area and hippocampus. A lot of proteins that are targeted in NPLE or Non-Paraneoplastic Limbic Encephalitis are recognized in the last 3 years. Symptoms vary depending on the type of protein targeted.

Signs and Symptoms of Limbic Encephalitis

Early symptoms of limbic encephalitis include headache and flu-like illness which are followed by some serious symptoms in a matter of few hours, days or even week. It can lead to loss of consciousness from mild drowsiness to complete unconsciousness or coma. Some other symptoms are seizures (fits), difficulty in speaking or controlling movement, high temperature, aversion to bright lights, stiffness of neck, sensory changes, or uncharacteristic behavior. Common signs and symptoms of limbic encephalitis irrespective of the type include seizures, confusion, movement disorders, hallucinations, altered personality or behavior, memory loss, psychosis, or sleep disturbances.

Complications in Limbic Encephalitis

Limbic encephalitis can cause various problems such as recurring headaches, tiredness and loss of memory, mood swings, concentration and balance, clumsiness and aggression. In some cases of encephalitis, epilepsy can occur after some weeks or months of illness. In also causes physical problems in body like loss of sensation, difficulty in controlling body movements and function, weakening of one part of the body, difficulty in speaking and controlling speech, reaction time and reflexes. Even the successful treatments of limbic encephalitis only the physical recovery is possible while the changes and complications in the personality cannot be recovered resulting into interruption of day to day functioning.

Tests to Diagnose Limbic Encephalitis

Tests to Diagnose Limbic Encephalitis

Doctor begins to suspect the occurrence of limbic encephalitis when there is a case of swelling or inflammation in brain. However it is difficult to diagnose limbic encephalitis as its symptoms are not unique and can vary from person to person. Even the rate of development of symptoms can be highly varying. Tests for diagnoses of limbic encephalitis include:

  • Brain scans such as Magnetic Resonance Imaging (MRI) or Computerized Tomography (CT) for Diagnosing Limbic Encephalitis: These methods for diagnosing limbic encephalitis help in ruling out the chances of aneurysms (a bulge in a blood vessel), brain tumors and strokes and determine the part of brain affected by inflammation.
  • Blood tests to Diagnose Limbic Encephalitis: These tests for diagnosing limbic encephalitis help in ruling out the chances of metabolic encephalopathy which refers to (neurological disorders resulting from systemic illnesses include renal failure, diabetes and heart failure).

Even if the results of these tests are normal, there are still chances of presence of some other diseases.

Treatment for Limbic Encephalitis

Limbic encephalitis causes inflammation in the limbic area of the brain that determines behavior, emotions and functions related to memory. This can lead to changes in personality, loss of memory, mood disturbance, and difficulty in sleeping or hallucinations.

It is very important to diagnose Autoimmune limbic encephalitis as it is possible to treat this type of Encephalitis using medicines that suppresses the immune system. Commonly used medications include steroids, immunoglobulin and plasma exchange. All these drugs have side effects but still it is widely used because of its advantages.

Home Remedies for Limbic Encephalitis

Encephalitis is a serious medical condition and thus it is not possible to treat the situation by any sort of home remedies. One needs to take proper medical care in the clinic or hospital under the supervision of the medical experts for successful treatment and recovery.

Recovery Period/Healing Time for Limbic Encephalitis

The recovery period/healing time for Inflammation in the brain due to limbic encephalitis can last for some days in most cases and can even continue for months. The patient can remain in coma or complete unconsciousness in case of acute illness in some cases. After the acute phase of limbic encephalitis, the patient shows rapid improvement for some time followed by gradual improvement which can last for years.

All the cases of limbic encephalitis are different with varying outcomes. Many patients reports occurrence of residual problems that can start once you get back to your home as you try to lead a normal life. Some of these problems can remain subdued while the person remains in the hospital and can remain undiscovered or unexplored as the disease is in recuperating phase. Outcomes of the treatment of limbic encephalitis can vary from person to person and some of them even return to their normal lifestyle without much difference in their abilities while others can suffer from profound disability both cognitively or physically. A few of the patients of limbic encephalitis may need a permanent residential care for the proper care.

The inflammation and infection caused by limbic encephalitis can cause serious damage to the cells and tissues of the brain. This type of damage to brain is referred as Acquired Brain Injury (ABI). The extent of damage to brain can vary from person to person from minor impairment like ability to think and react to serious impairment of brain leading to complete loss of memory. The extent of damage to the brain can vary significantly from person to person depending on various parameters such as which part of the brain is affected, extent of inflammation or any delay in the starting the treatment. The problems resulting from limbic encephalitis and its effects on the body mentally and physically are determined by the combination of all these parameters. Limbic encephalitis can result in various types of impairments including disability in the functioning of the body or change in personality even after there is complete recovery from the disease.

Disability Benefits for Limbic Encephalitis

Disability benefits can be very helpful for the victims of limbic encephalitis. A person and his family suffering from limbic encephalitis might have to face a serious financial crisis. In such scenario, sickness package paid by the company where the person was employed can be very handy. All companies are bound to pay at least Statutory Sick Pay, for a period of first 28 weeks after the illness.

However, it is not easy for the individual to get the claim. Moreover his physical and mental condition can further make it harder to and frustrating. A professional can help you get the financial compensation that you deserve in a swift manner with ease.

Those individuals qualifying for the low income group can get financial support from Income Support or Tax Credits. For claim settlement you can seek help from your local social worker, social worker at the hospital, or the disability benefits advisor at your local Citizen’s Advice Bureau. You can contact them on phone if not accessible directly.

Coping with Limbic Encephalitis

The problems resulting from limbic encephalitis can be very difficult to handle for a person and thus requires tough mental strength to cope up with limbic encephalitis. It can be very stressful and challenging for the person to deal with the problems of limbic encephalitis. The disease can lead to complete change in personality and physical abilities which is very hard for the person itself as well as for the persons with whom you have spent most of your life. This is also one of the major challenges that a person suffering from limbic encephalitis has to tackle.

In the process of treatment of limbic encephalitis, the foremost and the prime focus of the doctor and the experts are to create a safe environment and also push for spontaneous recovery of the patient. Once the phase of spontaneous recovery is over or slows down, there is focus on helping the patient to develop necessary skills strategies and habits that can help the patient suffering from limbic encephalitis in coping up with the mental and physical problems.

One need to understand that in case of limbic encephalitis, it can take a lot of time for the person and other people belonging to family and friends to adjust according to the situation presented due to the problems caused by limbic encephalitis. The situation calls for various types of adjustments including emotional and practical changes. There are many situations known in medical science where the persons in the family and friends may have to suffer from bereavement and thus family must be prepared for every type of situation and any length of time for complete recovery. However there are many people who are coping up with the situation very well with gradual recovery.

Exercises for Limbic Encephalitis

Exercising is always helpful in coping up with the stress and physical disabilities. It not only makes the body healthy but in such situation can become a part of the key strategies that allow you to cope up with limbic encephalitis.

Yoga for Limbic Encephalitis

Yoga is special type of physical activity that helps in developing focus and concentration by simple set of breathing and other exercises. Yoga can help in ease out the stress and recovery phase that can take several weeks in case of limbic encephalitis.

Prognosis/Outlook for Limbic Encephalitis

The prognosis/outlook for limbic encephalitis is dependent on many factors and so it is hard to predict the outcome. Some may heal faster while others take long time. It is very much possible to treat limbic encephalitis. NPLE or Non-Paraneoplastic Limbic Encephalitis is mainly caused due to antibodies that are voltage‐gated through potassium channel referred as VGKC‐Ab in short. These antibodies are known to affect especially the cerebrospinal fluid (CSF) of brain and also serum of patients who have shown good response against the various treatment procedures available.

Conclusion

Limbic encephalitis is only recently discovered and hence there is very little information and awareness about the disease among the professionals and clinicians. Researchers in future need to look for the biological mechanisms that cause antibodies to act against the body resulting into this disease of limbic encephalitis. Also there is need to find the complete list of antibodies that are responsible for autoimmune limbic encephalitis, so that it can be easily diagnosed.

Written, Edited or Reviewed By:

, MD, FFARCSI

Last Modified On: August 6, 2016

Pain Assist Inc.

Pramod Kerkar
  Note: Information provided is not a substitute for physician, hospital or any form of medical care. Examination and Investigation is necessary for correct diagnosis.

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