scholarly journals Characterising memory loss in patients with autoimmune limbic encephalitis hippocampal lesions

2019 ◽  
Author(s):  
Meher Lad ◽  
Sinéad L. Mullally ◽  
Alexandra L. Houston ◽  
Tom Kelly ◽  
Timothy D. Griffiths

AbstractSince the publication of Scoville and Milner’s (1957) seminal paper, the precise functional role played by the hippocampus in support of human memory has been fiercely debated. For instance, the single question of whether the hippocampus plays a time-limited or an indelible role in the recollection of personal memories led to a deep and tenacious schism within the field. Similar polarisations arose between those who debated the precise nature of the role played by the hippocampus in support of semantic relative to episodic memories and in recall/recollection relative to familiarity-based recognition. At the epicentre of these divisions lies conflicting neuropsychological findings. These differences likely arise due to the consistent use of heterogeneous patient populations to adjudicate between these positions. Here we utilised traditional neuropsychological measures in a homogenous patient population with a highly discrete hippocampal lesion (i.e. patients with voltage-gated potassium channel complex antibody associated limbic encephalitis (VGKC-LE)). We observed impairment of recent but not remote episodic memory, a preservation of semantic memory, and recall but not recognition memory deficits. We conclude that this increasingly well-characterised group of patients may represent an important homogeneous population in which the functional role played by the hippocampus may be more precisely delineated.

Hippocampus ◽  
2019 ◽  
Vol 29 (11) ◽  
pp. 1114-1120 ◽  
Author(s):  
Meher Lad ◽  
Sinéad L. Mullally ◽  
Alexandra L. Houston ◽  
Tom Kelly ◽  
Timothy D. Griffiths

Author(s):  
Camilla Buckle ◽  
Angela Vincent

Autoimmune limbic encephalitis—typical presentation is with acute or subacute onset of short term memory loss, seizures and disorientation. MRI characteristically shows striking abnormalities in the hippocampus. Antibodies against cell-surface proteins that are components of voltage-gated potassium channel (VGKC) complexes are found in a high proportion and are probably pathogenic. Aside from supportive care, treatment is with immunosuppression, often comprising corticosteroids with intravenous immunoglobulin and/or plasma exchange....


2021 ◽  
pp. 541-548
Author(s):  
José Alberto Choreño-Parra ◽  
Tania de la Rosa-Arredondo ◽  
André Garibay-Gracián ◽  
Ingrid Montes de Oca-Vargas ◽  
Deyanira Capi-Casillas ◽  
...  

The spectrum of autoimmune encephalitis (AE) encompasses several entities characterized by a variable frequency of psychiatric symptoms, cognitive dysfunction, focal deficits, and seizures. Although patients with AE can be categorized in specific syndromes, overlapping manifestations are also common. Furthermore, atypical correlations between clinical phenotypes and autoantibody profiles could occur in rare cases. Here, we report the rare case of a young adult man attending due to new-onset seizures and a history of memory loss, autonomic disturbances, headache, behavioral changes, and visual and olfactory hallucinations. The patient was subjected to a complete diagnostic approach that included a comprehensive laboratory workup, neuropsychological testing, electroencephalogram, cerebrospinal fluid (CSF) analysis, brain MRI, and positron emission tomography/computed tomography scan that revealed a functional and structural compromise of the bilateral medial temporal lobes. Together with the clinical manifestations of the patient, these findings were compatible with the diagnosis of autoimmune limbic encephalitis (ALE). Strikingly, further analysis of the CSF showed autoantibodies against the N-methyl-D-aspartate (NMDA) receptor. We found very few cases of the co-occurrence of anti-NMDA receptor antibodies and nonparaneoplastic ALE in the literature, especially in male patients. Our report exemplifies the complicated differential diagnosis of ALE and adds clinical information of the association with anti-NMDA receptor antibodies.


Author(s):  
Alessandro Dinoto ◽  
Marta Cheli ◽  
Miloš Ajčević ◽  
Franca Dore ◽  
Carmelo Crisafulli ◽  
...  

2012 ◽  
Vol 95 (4) ◽  
pp. 329-330 ◽  
Author(s):  
Akihito Fujimi ◽  
Yuki Ikeda ◽  
Kaoru Ono ◽  
Yuji Kanisawa

Hippocampus ◽  
2021 ◽  
Author(s):  
Christoph Mueller ◽  
Lisa M. Langenbruch ◽  
Johanna M. H. Rau ◽  
Tobias Brix ◽  
Christine Strippel ◽  
...  

2019 ◽  
pp. 567-597
Author(s):  
Shahar Shelly ◽  
Ram Narayan ◽  
Divyanshu Dubey

2017 ◽  
Vol 11 (1) ◽  
pp. 7-10 ◽  
Author(s):  
Spencer I. Rozin

Cognitive decline and dementia are a growing problem as the population ages. Effective therapies to prevent and treat these problems are limited. Neuro-inflammation has been suggested as a cause of dementia [1]. Montelukast is a leukotriene receptor antagonist used to treat seasonal allergies and asthma. It acts as a cysteinyl leukotriene (CysLT1) receptor antagonist blocking the action of leukotrienes and decreasing inflammation [2]. Animal studies have shown that administering Montelukast improves memory function [3]. This case series of patients in a private Internal Medicine practice between 2013-2014 used Montelukast in patients with various levels of memory impairment and dementia. Patients were given Montelukast 80 mg daily in 4 divided doses every 2-3 hours. Memory impaired patients had subjective improvement in the memory and recall. Patients with dementia were noted by family members to be less agitated, but had no memory improvement at the doses used. Montelukast may be useful to treat memory impairment and dementia. Long term use might act as a prophylactic to prevent dementia.


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