Successful treatment of emotional disturbances following non-herpetic limbic encephalitis by serotonergic agents. A case report

Koichi Narikawa, Takafumi Hasegawa, Atsushi Takeda, Yuusei Shiga, Yasuto Itoyama

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)

Abstract

We report a 19-year-old woman who developed refractory status epilepticus due to non-herpetic limbic encephalitis. Because ordinary anti-epileptics were ineffective, general anesthesia under mechanical ventilation was begun with pentobarbital, midazolam, and propofol. After 4 months, we could finally discontinue the intravenous anesthetics. Then, she gradually became conscious and several weeks later, could communicate verbally. Simultaneously, she began to manifest psychomotor agitation and emotional incontinence mimicking Klüver-Bucy syndrome. Brain MRI revealed cortical atrophy in the fronto-temporal lobes and dilated anterior and inferior horns of the lateral ventricles. Dopamine blockers and benzodiazepines failed to resolve these emotional symptoms. Oral tandospirone (30 mg/day dose) was initiated and a partial regression was observed. The following administration of fluvoxamine (started with 12.5 mg/day and maintained with 75 mg/day) resulted in a dramatic improvement of her symptoms within 3 days. This clinical course suggests that impaired serotonergic neurotransmission plays a key role in her emotional disturbances and that its modulation by serotonergic agents is useful to relieve such symptoms.

Original languageEnglish
Pages (from-to)805-808
Number of pages4
JournalClinical Neurology
Volume41
Issue number11
Publication statusPublished - 2001 Nov 1

Keywords

  • Emotional disturbances
  • Klüver-Bucy syndrome
  • Limbic encephalitis
  • SSRI
  • Serotonin

ASJC Scopus subject areas

  • Clinical Neurology

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