A rare and treatable cause for his illness was found. has been treated successfully and offers been able to return to work. This is a rare case of limbic encephalitis to have a good prognosis, absent antibodies and no underlying identifiable malignancy. Case demonstration ? Presenting features C misunderstandings, disorientation ? Recent medical/surgery history C neurofibromatosis type 1, temporal lobe epilepsy ? Sociable history C non-smoker, minimal alcohol, machine setter. Investigations ? Haemoglobin 18 g/dl ? Autoimmune antibodies Yo, Hu, Ma, Ta, cv2, amphiphysin and VGKC antibodies C bad ? MRI C limbic encephalitis (number 1A). Open in a separate window Open in a separate window Number 1 (A) Mind MRI scan on admission showing evidence of the abnormally Saccharin 1-methylimidazole high transmission on T2 imaging Saccharin 1-methylimidazole associated with improved transmission in the remaining limbic tract and the medial aspect of the remaining temporal horn of the lateral ventricle. (B) A follow-up mind MRI scan 6 months after demonstration showed significant reduction in the transmission switch in the left temporal lobe and limbic tract. ? Full body CT C no abnormality. ? PSA+testicular ultrasound scan C no abnormality. ? Cerebrospinal fluid results: white blood cells 0, reddish blood cells 0, no growth, glucose 3.4, protein 0.55 ? Herpes, EBV and cytomegalovirus PCR C bad. ? Syphilis serology C Saccharin 1-methylimidazole bad. Differential analysis ? Herpes simplex encephalitis. Treatment ? Saccharin 1-methylimidazole Intravenous aciclovir ? Intravenous immunoglobulin (Vigam) ? Venesection. End result and follow-up ? Clinical and radiological improvement (number 1B). The patient is now traveling and offers been able to return to work. ? All autoimmune antibodies bad. ? No malignancy found. ? The patient has been followed up regularly now for 2 years and a repeat full body CT scan performed 23 weeks after the onset of Procr symptoms offers found no malignancy. He will continue to be adopted up on a 6-regular monthly basis. Discussion You will find two types of limbic encephalitis, paraneoplastic and non-paraneoplastic.1 We believe that our patient has non-paraneoplastic limbic encephalitis, a disorder that is documented in the literature. Non-paraneoplastic limbic encephalitis is definitely a rare treatable cause of encephalitis. No known association between limbic encephalitis and neurofibromatosis has been reported and all documented cases were found to be associated with antibodies with or without malignancy. Saccharin 1-methylimidazole The impressive feature in this case is the considerable medical and radiological improvement with this patient’s condition to the point that he offers been able to return to work. Generally the condition carries a poor prognosis owing to the known association with malignancy.1 3 6C8 The excellent progress of the clinical condition in our patient makes hidden underlying malignancy extremely unlikely. The memory space impairment is often irreversible and both these features of the condition possess a serious and distressing effect on the patient and the carer’s quality of life.9 Learning points ? Limbic encephalitis is definitely a rare disorder characterised by feeling and behavioural changes and short-term memory space problems, with characteristic findings on MRI scan.1 2 4 5 ? It is generally associated with antibodies against intra-cellular or classic paraneoplastic antigens and cell membrane antigens.5 ? The disorder typically bears with it a poor prognosis owing to its strong association with malignancy, most commonly small cell lung malignancy.1 3 6C8 ? Our individual proved to have a type.