Neuropsychological Evaluations in Limbic Encephalitis
Limbic encephalitis (LE) can cause dynamic and permanent impairment of cognition and behavior. In clinical practice, the question arises as to which cognitive and behavioral domains are affected by LE and which assessment is suited to monitor the disease progress and the success of treatment. Curren...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-04-01
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| Series: | Brain Sciences |
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| Online Access: | https://www.mdpi.com/2076-3425/11/5/576 |
| _version_ | 1827693709670481920 |
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| author | Juri-Alexander Witt Christoph Helmstaedter |
| author_facet | Juri-Alexander Witt Christoph Helmstaedter |
| author_sort | Juri-Alexander Witt |
| collection | DOAJ |
| description | Limbic encephalitis (LE) can cause dynamic and permanent impairment of cognition and behavior. In clinical practice, the question arises as to which cognitive and behavioral domains are affected by LE and which assessment is suited to monitor the disease progress and the success of treatment. Current findings on cognition and behavior in LE are reviewed and discussed based on current guidelines and consensus papers. In addition, we outline approaches for the neuropsychological monitoring of LE and its treatment. Dependent on disease acuity and severity, LE leads to episodic long-term memory dysfunction in different variants (e.g., anterograde memory impairment, accelerated long-term forgetting, and affection of autobiographical memory) and executive deficits. In addition, affective disorders are very common. More severe psychiatric symptoms may occur as well. In the course of the disease, dynamic phases with functional recovery must be differentiated from residual defect states. Evidence-based neuropsychological diagnostics should be conducted ideally before treatment initiation and reassessments are indicated when any progress is suggested, and when decisive anti-seizure or immunomodulatory treatment changes are made. Cognition and behavior may but must not run in synchrony with seizures, MRI pathology, or immune parameters. Cognitive and behavioral problems are integral aspects of LE and represent important biomarkers of disease acuity, progress, and therapy response beyond and in addition to parameters of immunology, neurological symptoms, and brain imaging. Thus, evidence-based neuropsychological assessments are essential for the diagnostic workup of patients with suspected or diagnosed limbic encephalitis, for treatment decisions, and disease and treatment monitoring. |
| first_indexed | 2024-03-10T11:49:17Z |
| format | Article |
| id | doaj.art-80e5d2e3325d49e48de1f5fa0e3a58ce |
| institution | Directory Open Access Journal |
| issn | 2076-3425 |
| language | English |
| last_indexed | 2024-03-10T11:49:17Z |
| publishDate | 2021-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Brain Sciences |
| spelling | doaj.art-80e5d2e3325d49e48de1f5fa0e3a58ce2023-11-21T17:48:43ZengMDPI AGBrain Sciences2076-34252021-04-0111557610.3390/brainsci11050576Neuropsychological Evaluations in Limbic EncephalitisJuri-Alexander Witt0Christoph Helmstaedter1Department of Epileptology, University Hospital Bonn (UKB), 53127 Bonn, GermanyDepartment of Epileptology, University Hospital Bonn (UKB), 53127 Bonn, GermanyLimbic encephalitis (LE) can cause dynamic and permanent impairment of cognition and behavior. In clinical practice, the question arises as to which cognitive and behavioral domains are affected by LE and which assessment is suited to monitor the disease progress and the success of treatment. Current findings on cognition and behavior in LE are reviewed and discussed based on current guidelines and consensus papers. In addition, we outline approaches for the neuropsychological monitoring of LE and its treatment. Dependent on disease acuity and severity, LE leads to episodic long-term memory dysfunction in different variants (e.g., anterograde memory impairment, accelerated long-term forgetting, and affection of autobiographical memory) and executive deficits. In addition, affective disorders are very common. More severe psychiatric symptoms may occur as well. In the course of the disease, dynamic phases with functional recovery must be differentiated from residual defect states. Evidence-based neuropsychological diagnostics should be conducted ideally before treatment initiation and reassessments are indicated when any progress is suggested, and when decisive anti-seizure or immunomodulatory treatment changes are made. Cognition and behavior may but must not run in synchrony with seizures, MRI pathology, or immune parameters. Cognitive and behavioral problems are integral aspects of LE and represent important biomarkers of disease acuity, progress, and therapy response beyond and in addition to parameters of immunology, neurological symptoms, and brain imaging. Thus, evidence-based neuropsychological assessments are essential for the diagnostic workup of patients with suspected or diagnosed limbic encephalitis, for treatment decisions, and disease and treatment monitoring.https://www.mdpi.com/2076-3425/11/5/576limbic encephalitisautoimmune epilepsyneuropsychologycognitionbehaviormonitoring |
| spellingShingle | Juri-Alexander Witt Christoph Helmstaedter Neuropsychological Evaluations in Limbic Encephalitis Brain Sciences limbic encephalitis autoimmune epilepsy neuropsychology cognition behavior monitoring |
| title | Neuropsychological Evaluations in Limbic Encephalitis |
| title_full | Neuropsychological Evaluations in Limbic Encephalitis |
| title_fullStr | Neuropsychological Evaluations in Limbic Encephalitis |
| title_full_unstemmed | Neuropsychological Evaluations in Limbic Encephalitis |
| title_short | Neuropsychological Evaluations in Limbic Encephalitis |
| title_sort | neuropsychological evaluations in limbic encephalitis |
| topic | limbic encephalitis autoimmune epilepsy neuropsychology cognition behavior monitoring |
| url | https://www.mdpi.com/2076-3425/11/5/576 |
| work_keys_str_mv | AT jurialexanderwitt neuropsychologicalevaluationsinlimbicencephalitis AT christophhelmstaedter neuropsychologicalevaluationsinlimbicencephalitis |