Table 2

Autoantibodies relevant for the diagnostic work-up of limbic encephalitis

AbsiIHCBlotRIAELISACBA
Abs to intracellular antigens
 Onconeural Abs (anti-Hu, Ma1/2, CV2 (CRMP5), amphiphysin, Sox1)++
 GAD++++
Abs to membranous antigens
 VGKC*++
 NMDAR+++
 AMPAR++
 GABA(B)R++
  • Please note that IHC results always need confirmation by another method.

  • * It has recently been found that these antibodies are often against components of VGKC complexes, such as Lgi1 and Caspr2, rather than necessarily against the VGKCs themselves.34 35 In the future, antibody testing for these specific targets will become available, but their relevance to childhood encephalitis is not yet known.

  • These Abs are mentioned here because they may occasionally be found with the clinico-radiological syndrome of limbic encephalitis (as opposed to the diffuse, stage-wise encephalopathy called anti-NMDAR encephalitis).38

  • Abs, autoantibodies; AMPAR, α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor; CBA, cell based assay; ELISA, enzyme linked immunosorbent assay; GABA(B)R, γ-aminobutyric acid B receptor; GAD, glutamic acid decarboxylase; iIHC, indirect immunohistochemistry (immunofluorescence); NMDAR, N-methyl-d-aspartate receptor; RIA, radioimmunoprecipitation assay; VGKC, voltage-gated potassium channels.