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Hypothermia in VGKC antibody-associated limbic encephalitis
  1. S Jacob1,2,3,
  2. S R Irani1,
  3. Y A Rajabally2,
  4. A Grubneac3,
  5. R J Walters4,
  6. M Yazaki5,
  7. L Clover1,
  8. A Vincent1
  1. 1
    The Neurosciences Group, Weatherall Institute of Molecular Medicine and Department of Clinical Neurology, John Radcliffe Hospital, Headington, Oxford, UK
  2. 2
    Department of Neurology, University Hospitals of Leicester, Leicester, UK
  3. 3
    Department of Neurology, University Hospitals of Coventry and Warwickshire NHS Trust, Coventry, UK
  4. 4
    Department of Neurology, Morriston Hospital, Swansea, UK
  5. 5
    Third Department of Medicine, Shinshu University School of Medicine, Matsumoto, Japan
  1. Prof Angela Vincent, Department of Clinical Neurology, Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, Headington, Oxford OX3 9DS, UK; angela.vincent{at}imm.ox.ac.uk

Abstract

Voltage-gated potassium channel antibody (VGKC-Ab)-associated limbic encephalitis (LE) is a recently described syndrome that broadens the spectrum of immunotherapy-responsive central nervous system disorders. Limbic encephalitis is typically characterised by a sub-acute onset of disorientation, amnesia and seizures, but the clinical spectrum is not yet fully defined and the syndrome could be under-diagnosed. We here describe the clinical profile of four patients with VGKC-Ab-associated LE who had intermittent, episodic hypothermia. One of the patients also described a prodrome of severe neuropathic pain preceding the development of limbic symptoms. Both of these novel symptoms responded well to immunosuppressive therapy, with concurrent amelioration of amnesia/seizures.

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Footnotes

  • Funding: This work was supported in part by a grant from the DANA Foundation. SI is supported by the National Institute of Health Research, Department of Health, UK.

  • Competing interests: The University Department of Clinical Neurology in Oxford receives royalties and payments for VGKC and other antibody assays.