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Diagnostic spectrum of limbic encephalitis
The highly specific tests for anti-Hu, anti-Ma, anti-amphiphysin and anti-CV2/CRMP5 antibodies have been an important tool in the diagnosis of paraneoplastic limbic encephalitis (PLE).1 The testing procedure for these antibodies is two tiered. Firstly, patients’ sera are incubated with brain slices from a paraformaldehyde-perfused animal (usually rat or monkey). Specific binding patterns to brain cells allow the identification of the above-named “well-characterised” antibodies. After this immunohistochemical test, a confirmatory blotting test is performed on the brain homogenate (in comparison with a positive control) or on the suspected antigen as recombinant protein. For both techniques, testing of serum is more sensitive than testing of cerebrospinal fluid (CSF). The antibodies detected in this way react with intracellular antigens. They portend a poor …
Competing interests: None declared.