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UNLABELLED: Recently, a new subtype of limbic encephalitis (LE) has been described, serologically characterized by the presence of antibodies against voltage gated potassium channels (VGKC, to be called VGKC-LE). Only little is known about CSF findings in this new disorder. Here we report the results of 29 lumbar punctures in 17 patients with VGKC-LE. Slight pleocytosis, mainly consisting of lymphocytes and monocytes, and elevated total protein concentrations were present in 41 and 47%, respectively. Intrathecal immunoglobulin (Ig) synthesis as defined by the presence of CSF-specific oligoclonal IgG bands, an increased IgG index, or an elevated IgG, IgA, or IgM ratio, was not detected in any of the patients, but dysfunction of the blood-CSF barrier was found in 35%. CSF findings were normal in 23%. CONCLUSIONS: Unlike paraneoplastic LE, VGKC-LE is not frequently associated with intrathecal Ig production or markedly elevated white cell counts. Thus, normal CSF findings do not preclude the disease. VGKC-Ab should, therefore, be determined whenever LE is clinically suspected, irrespective of the presence or absence of inflammatory CSF changes.

Original publication

DOI

10.1016/j.jns.2007.11.004

Type

Journal article

Journal

J Neurol Sci

Publication Date

15/05/2008

Volume

268

Pages

74 - 77

Keywords

Adult, Aged, Aged, 80 and over, Female, Humans, Isoelectric Focusing, Lactic Acid, Leukocyte Count, Limbic Encephalitis, Male, Middle Aged, Oligoclonal Bands, Potassium Channels, Voltage-Gated, Retrospective Studies