Usually viral - usually HSV, VZV and other herpes group viruses, HHV-6, 7, enteroviruses and adenovirus
Limbic encephalitis is a form of antibody-mediated encephalitis
May be associated with underlying malignancy or autoimmune
Clinical presentation
Fever (90%)
Meningism
Personality and behavioural change, which progresses to a reduced level of consciousness and even coma
Seizures (focal and generalised)
Focal neurological deficits, such as speech disturbance
Investigations
MRI - bilateral medial temporal lobe involvement
EEG
CSF
Viral - elevated lymphocytes, viral detection by CSF PCR
Limbic - antibodies may be identifiable
Management
Suspected HSV and VZV encephalitis is treated immediately with intravenous aciclovir, even before investigation results are available - significantly improves outcomes
Management of limbic encephalitis depends on cause - treat tumour, immunosuppressive treatment
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