Limbic encephalitis
Subacute amnesia, seizures and psychiatric change from inflammation of the medial temporal lobes; the Graus 2016 criteria, which antibody goes with which picture and tumour, why aciclovir comes first and immunotherapy shouldn't wait for the antibody result.
Tier 2Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Inflammation of the hippocampi and amygdalae: subacute memory loss, seizures and psychiatric change over days to weeks.
- Causes are autoimmune (antibody-mediated or paraneoplastic) or infective, mainly HSV. Autoimmune encephalitis is now about as common as infectious encephalitis.
- Start aciclovir until HSV is excluded. Then start immunotherapy early, before antibody results return.
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Sources
- Therapeutic Guidelines: NeurologyAU/NZTherapeutic Guidelines Limited
- A clinical approach to diagnosis of autoimmune encephalitis (Graus F et al. Lancet Neurol 2016;15(4):391-404)Lancet Neurology, 2016
- Updated diagnostic criteria for paraneoplastic neurologic syndromes (Graus F et al. Neurol Neuroimmunol Neuroinflamm 2021;8(4):e1014)Neurology Neuroimmunology & Neuroinflammation, 2021
- Management of suspected infectious and autoimmune encephalitis in adults: national guidelines from the United Kingdom Joint Societies (Michael BD et al. J Infect 2026;106873)Journal of Infection, 2026
- Canadian consensus guidelines for the diagnosis and treatment of autoimmune encephalitis in adults (Hahn C et al. Can J Neurol Sci 2024)Canadian Journal of Neurological Sciences, 2024
- Autoimmune encephalitis: proposed best practice recommendations for diagnosis and acute management (Abboud H et al. J Neurol Neurosurg Psychiatry 2021;92(7):757-768)Journal of Neurology, Neurosurgery and Psychiatry, 2021
- Treatment and prognostic factors for long-term outcome in patients with anti-NMDA receptor encephalitis (Titulaer MJ et al. Lancet Neurol 2013;12(2):157-165)Lancet Neurology, 2013
- Intravenous immunoglobulin in autoimmune encephalitis in adults (ENCEPH-IG): randomised placebo-controlled trial (Ellul M et al. NIHR Open Res 2026)NIHR Open Research, 2026
- Randomized placebo-controlled trial of intravenous immunoglobulin in autoimmune LGI1/CASPR2 epilepsy (Dubey D et al. Ann Neurol 2020;87(2):313-323)Annals of Neurology, 2020
- Frequency, symptoms, risk factors, and outcomes of autoimmune encephalitis after herpes simplex encephalitis (Armangue T et al. Lancet Neurol 2018;17(9):760-772)Lancet Neurology, 2018
- Criteria for the clinical use of immunoglobulin in AustraliaAU/NZNational Blood Authority
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Personal emails, About story and Australian-style copy