Abstract
Background
Non-paraneoplastic limbic encephalitis is characterized by attention deficit, loss
of emotion control, and impaired memory. Viral infection can cause acute encephalitis
in children, occasionally exhibiting clinical features of limbic dysfunction. However,
how viral infection affects the limbic system remains to be elucidated.
Case description
A 5-year-old Japanese boy was admitted to our hospital because of high fever and status
epilepticus. After seizures were controlled by diazepam, he exhibited attention deficit,
loss of emotion control, and impaired memory, suggesting acute limbic encephalitis.
Since titers of antibodies against Coxsackie virus A10 were significantly elevated
in the serum, we diagnosed him with non-paraneoplastic limbic encephalitis associated
with the viral infection. Brain magnetic resonance imaging demonstrated involvement
of anterior cingulate cortex as well as white matter of the frontal lobe in the acute
period. After steroid pulse therapy, these brain lesions subsequently disappeared
in a time-dependent manner, beginning with the frontal lobe white matter and extending
to the anterior cingulate cortex, and his psychological symptoms also disappeared.
Conclusion
To the best of our knowledge, this is the first report to show the involvement of
the region from the anterior cingulate cortex to the frontal lobe white matter. Clinical
features such as seizures, attention deficit, loss of emotion control, and impaired
memory suggest that this viral limbic encephalitis possibly extended from the frontal
white matter to the anterior cingulate cortex via inter-neuronal connections in a
time-dependent manner.
Keywords
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Article info
Publication history
Published online: April 17, 2019
Accepted:
April 7,
2019
Received in revised form:
March 26,
2019
Received:
October 29,
2018
Identification
Copyright
© 2019 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.
