Loss of Autonoetic Awareness of Recent Autobiographical Episodes and Accelerated Long-Term Forgetting in a Patient with Previously Unrecognized Glutamic Acid Decarboxylase Antibody Related Limbic Encephalitis.

摘要: We describe a 35-year old male patient presenting with depressed mood and emotional instability who complained about severe anterograde retrograde memory deficits characterized by accelerated long-term forgetting loss of autonoetic consciousness regarding autobiographical memories the last three years. Months before he had experienced two breakdowns unknown etiology giving rise to differential diagnosis epileptic seizures after various practitioners clinics suggested different etiologies such as psychosomatic condition, burnout, depression or dissociative amnesia. Neuropsychological assessment indicated selectively impaired figural performance. Extended diagnostics confirmed previously learned retrievable verbal material. Structural imaging showed bilateral swelling signal alterations temporomesial structures (left > right). Video-EEG monitoring revealed left temporal focus subclincal seizure, but no overt seizures. Antibody tests in serum liquor were positive for glutamic acid decarboxylase antibodies. These findings led antibody related limbic encephalitis. Monthly steroid pulses over six months recovery subjective intermediate improvement subsequent worsening objective During course treatment reported de novo paroxysmal non-responsive states. Thus, antiepileptic was started finally became seizure free. At visit vocational reintegration successfully progress. In conclusion, amygdala swelling, biographic impairment, may serve indicators encephalitis, even absence The patients calls standardized concerted multilevel diagnostic approach repeated assessments.