Limbic Encephalitis

Limbic encephalitis is a condition whereby the limbic regions of the brain become inflamed and cease to function properly. It predominantly affects the medial temporal lobes (hippocampus, amygdalae) and orbitofrontal cortex, which are areas involved in memory, learning and emotional regulation.

Causes of limbic encephalitis fall into two broad categories:

• Infectious encephalitis is caused by direct attack of the limbic regions by a virus.
• Autoimmune encephalitis is caused by one's own immune system reacting against parts of the limbic system. Some cases are associated with cancer while others are not. 

• Rapidly progressive memory deficits
  
• Psychiatric disturbances (hallucinations, delusions)
  
• Behavioural disturbances (confusion, agitation, social withdrawal)
  
• Seizures
  
• Motor abnormalities

The psychiatric team works very closely with the neurological team to provide optimal care for patients with limbic encephalitis. Neurologists may give medication to dampen down the immune system (immunosuppressant including steroids, immunoglobulin and plasma exchange). Additionally, psychiatrists may prescribe antidepressants, antipsychotics and/or mood stabilisers to help manage psychiatric symptoms. 

• Dr Cyrus Ho