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Ross
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### Selected Images
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*Axial FLAIR MR shows abnormal hyperintensity in the bilateral medial temporal lobes <img src='/img/arrows/CS.png'/>, characteristic of limbic encephalitis (LE), the most common paraneoplastic syndrome. Bilateral involvement is typical of limbic encephalitis.*
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*Axial FLAIR MR shows abnormal hyperintensity in the bilateral medial temporal lobes <img src='img/arrows/CS.png'/>, characteristic of limbic encephalitis (LE), the most common paraneoplastic syndrome. Bilateral involvement is typical of limbic encephalitis.*
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*Axial FLAIR MR shows abnormal hyperintensity in the bilateral medial temporal lobes <img src='/img/arrows/CS.png'/>, characteristic of limbic encephalitis (LE), the most common paraneoplastic syndrome. Bilateral involvement is typical of limbic encephalitis.*
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*Axial FLAIR MR shows abnormal hyperintensity in the bilateral medial temporal lobes <img src='img/arrows/CS.png'/>, characteristic of limbic encephalitis (LE), the most common paraneoplastic syndrome. Bilateral involvement is typical of limbic encephalitis.*
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*Axial FLAIR MR shows abnormal hyperintensity in the bilateral medial temporal lobes <img src='/img/arrows/CS.png'/>, characteristic of limbic encephalitis (LE), the most common paraneoplastic syndrome. Bilateral involvement is typical of limbic encephalitis.*
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*Axial FLAIR MR shows abnormal hyperintensity in the bilateral medial temporal lobes <img src='img/arrows/CS.png'/>, characteristic of limbic encephalitis (LE), the most common paraneoplastic syndrome. Bilateral involvement is typical of limbic encephalitis.*
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*Axial T1 C+ MR in the same patient shows no significant enhancement in the medial temporal lobes. Enhancement is often present in limbic encephalitis. The patient's symptoms often improve after treatment of the primary tumor.*
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*Axial T1 C+ MR in the same patient shows no significant enhancement in the medial temporal lobes. Enhancement is often present in limbic encephalitis. The patient's symptoms often improve after treatment of the primary tumor.*
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*Axial FLAIR MR in a 61 year old with multiple myeloma who presented with seizures shows abnormal hyperintensity <img src='/img/arrows/CS.png'/> in the cortex and subcortical white matter of the temporal lobes.*
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*Axial FLAIR MR in a 61 year old with multiple myeloma who presented with seizures shows abnormal hyperintensity <img src='img/arrows/CS.png'/> in the cortex and subcortical white matter of the temporal lobes.*
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*Axial FLAIR MR in a 61 year old with multiple myeloma who presented with seizures shows abnormal hyperintensity <img src='/img/arrows/CS.png'/> in the cortex and subcortical white matter of the temporal lobes.*
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*Axial FLAIR MR in a 61 year old with multiple myeloma who presented with seizures shows abnormal hyperintensity <img src='img/arrows/CS.png'/> in the cortex and subcortical white matter of the temporal lobes.*
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*Axial T1 C+ FS MR in the same patient shows no enhancement. Differential considerations include autoimmune encephalitis (AE), acute demyelinating encephalomyelitis (ADEM), viral encephalitis, and vasculitis in this case. AE related to GABAr was diagnosed by CSF and serum markers.*
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*Axial T1 C+ FS MR in the same patient shows no enhancement. Differential considerations include autoimmune encephalitis (AE), acute demyelinating encephalomyelitis (ADEM), viral encephalitis, and vasculitis in this case. AE related to GABAr was diagnosed by CSF and serum markers.*
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*Axial FLAIR MR in a 71 year old with altered mental status shows abnormal hyperintensity in the left temporal lobe <img src='/img/arrows/CS.png'/>. Differential considerations include infectious, inflammatory, and neoplastic etiologies. GAD65 AE was diagnosed at brain biopsy.*
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*Axial FLAIR MR in a 71 year old with altered mental status shows abnormal hyperintensity in the left temporal lobe <img src='img/arrows/CS.png'/>. Differential considerations include infectious, inflammatory, and neoplastic etiologies. GAD65 AE was diagnosed at brain biopsy.*
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*Axial FLAIR MR in a 71 year old with altered mental status shows abnormal hyperintensity in the left temporal lobe <img src='/img/arrows/CS.png'/>. Differential considerations include infectious, inflammatory, and neoplastic etiologies. GAD65 AE was diagnosed at brain biopsy.*
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*Axial FLAIR MR in a 71 year old with altered mental status shows abnormal hyperintensity in the left temporal lobe <img src='img/arrows/CS.png'/>. Differential considerations include infectious, inflammatory, and neoplastic etiologies. GAD65 AE was diagnosed at brain biopsy.*
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*Axial FLAIR MR shows hyperintensity in the medial temporal lobes <img src='/img/arrows/CS.png'/> in this patient with subacute dementia and voltage-gated potassium channel (VGKC) autoimmunity. VGKC may occur with or without a primary neoplasm and may have an LE pattern.*
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*Axial FLAIR MR shows hyperintensity in the medial temporal lobes <img src='img/arrows/CS.png'/> in this patient with subacute dementia and voltage-gated potassium channel (VGKC) autoimmunity. VGKC may occur with or without a primary neoplasm and may have an LE pattern.*
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*Axial FLAIR MR shows hyperintensity in the medial temporal lobes <img src='/img/arrows/CS.png'/> in this patient with subacute dementia and voltage-gated potassium channel (VGKC) autoimmunity. VGKC may occur with or without a primary neoplasm and may have an LE pattern.*
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*Axial FLAIR MR shows hyperintensity in the medial temporal lobes <img src='img/arrows/CS.png'/> in this patient with subacute dementia and voltage-gated potassium channel (VGKC) autoimmunity. VGKC may occur with or without a primary neoplasm and may have an LE pattern.*
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*Axial T2 MR shows midbrain hyperintensity <img src='/img/arrows/CS.png'/> related to brainstem encephalitis, which is characterized by hyperintensity in the midbrain, pons, cerebellar peduncle, and basal ganglia.*
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*Axial T2 MR shows midbrain hyperintensity <img src='img/arrows/CS.png'/> related to brainstem encephalitis, which is characterized by hyperintensity in the midbrain, pons, cerebellar peduncle, and basal ganglia.*
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*Axial T2 MR shows midbrain hyperintensity <img src='/img/arrows/CS.png'/> related to brainstem encephalitis, which is characterized by hyperintensity in the midbrain, pons, cerebellar peduncle, and basal ganglia.*
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*Axial T2 MR shows midbrain hyperintensity <img src='img/arrows/CS.png'/> related to brainstem encephalitis, which is characterized by hyperintensity in the midbrain, pons, cerebellar peduncle, and basal ganglia.*
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*Axial T1 C+ MR in the same patient shows patchy enhancement of the midbrain lesions <img src='/img/arrows/CS.png'/> and the medial temporal lobe <img src='/img/arrows/CO.png'/>. This patient was diagnosed with LE with new brainstem symptoms. Multiple paraneoplastic syndromes may occur in the same patient.*
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*Axial T1 C+ MR in the same patient shows patchy enhancement of the midbrain lesions <img src='img/arrows/CS.png'/> and the medial temporal lobe <img src='img/arrows/CO.png'/>. This patient was diagnosed with LE with new brainstem symptoms. Multiple paraneoplastic syndromes may occur in the same patient.*
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*Axial T1 C+ MR in the same patient shows patchy enhancement of the midbrain lesions <img src='/img/arrows/CS.png'/> and the medial temporal lobe <img src='/img/arrows/CO.png'/>. This patient was diagnosed with LE with new brainstem symptoms. Multiple paraneoplastic syndromes may occur in the same patient.*
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*Axial T1 C+ MR in the same patient shows patchy enhancement of the midbrain lesions <img src='img/arrows/CS.png'/> and the medial temporal lobe <img src='img/arrows/CO.png'/>. This patient was diagnosed with LE with new brainstem symptoms. Multiple paraneoplastic syndromes may occur in the same patient.*
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*Axial FLAIR MR shows abnormal hyperintensity in the medial temporal lobes bilaterally, related to LE. As imaging mimics herpes encephalitis, most patients are initially treated with antiviral therapy until HSV titers are found to be negative. < 1% of cancer patients develop a paraneoplastic syndrome.*
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*Axial FLAIR MR shows abnormal hyperintensity in the medial temporal lobes bilaterally, related to LE. As imaging mimics herpes encephalitis, most patients are initially treated with antiviral therapy until HSV titers are found to be negative. < 1% of cancer patients develop a paraneoplastic syndrome.*
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*Axial T1 C+ MR in the same patient shows patchy enhancement <img src='/img/arrows/CO.png'/> of the medial temporal lobes. LE is the only paraneoplastic syndrome with defined imaging features.*
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*Axial T1 C+ MR in the same patient shows patchy enhancement <img src='img/arrows/CO.png'/> of the medial temporal lobes. LE is the only paraneoplastic syndrome with defined imaging features.*
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### Additional Images
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*Axial T2 MR shows abnormal hyperintensity in the right medial temporal lobe <img src='/img/arrows/CO.png'/>, typical of limbic encephalitis. Note the abnormal hyperintensity in the midbrain <img src='/img/arrows/CS.png'/>, indicative of brainstem encephalitis. Brainstem encephalitis is a very uncommon paraneoplastic syndrome. Multiple paraneoplastic syndromes can occur in the same patient.*
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*Axial T2 MR shows abnormal hyperintensity in the right medial temporal lobe <img src='img/arrows/CO.png'/>, typical of limbic encephalitis. Note the abnormal hyperintensity in the midbrain <img src='img/arrows/CS.png'/>, indicative of brainstem encephalitis. Brainstem encephalitis is a very uncommon paraneoplastic syndrome. Multiple paraneoplastic syndromes can occur in the same patient.*
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*Axial FLAIR MR in a patient with subacute dementia and lung cancer shows hyperintensity within the medial temporal lobes, classic for limbic encephalitis. Imaging mimics herpes encephalitis.*
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*Axial T1 C+ MR shows subtle patchy enhancement of the medial temporal lobes bilaterally <img src='/img/arrows/CS.png'/>, which is a typical enhancement pattern for limbic encephalitis. Bilateral involvement is common.*
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*Axial T1 C+ MR shows subtle patchy enhancement of the medial temporal lobes bilaterally <img src='img/arrows/CS.png'/>, which is a typical enhancement pattern for limbic encephalitis. Bilateral involvement is common.*
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*Coronal T2 MR in a patient with limbic encephalitis shows abnormal hyperintensity in the medial temporal lobes and right insula <img src='/img/arrows/CS.png'/> in this patient with severe memory loss and dementia. Symptoms improved after the removal of the primary tumor.*
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*Coronal T2 MR in a patient with limbic encephalitis shows abnormal hyperintensity in the medial temporal lobes and right insula <img src='img/arrows/CS.png'/> in this patient with severe memory loss and dementia. Symptoms improved after the removal of the primary tumor.*
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*Coronal T1 C+ MR shows abnormal gyriform enhancement in the medial temporal lobes and left insula <img src='/img/arrows/CS.png'/>. The more typical patchy enhancement pattern of limbic encephalitis is seen in the hippocampi bilaterally.*
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*Coronal T1 C+ MR shows abnormal gyriform enhancement in the medial temporal lobes and left insula <img src='img/arrows/CS.png'/>. The more typical patchy enhancement pattern of limbic encephalitis is seen in the hippocampi bilaterally.*
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*Axial T1 MR shows hyperintensity representing blood products in the medial temporal lobes in this patient with treated lung cancer and limbic encephalitis. Blood products are rare in limbic encephalitis, in which imaging mimics herpes encephalitis.*
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*Axial FLAIR MR shows abnormal hyperintensity in the medial temporal lobes bilaterally, characteristic of limbic encephalitis, the most common paraneoplastic syndrome. Bilateral involvement is typical of limbic encephalitis.*
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*Axial FLAIR MR in an older adult with small cell lung cancer and subacute dementia shows striking hyperintensity in the right insula <img src='/img/arrows/WO.png'/>.*
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*Axial FLAIR MR in an older adult with small cell lung cancer and subacute dementia shows striking hyperintensity in the right insula <img src='img/arrows/WO.png'/>.*
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*Coronal T2 MR in the same patient shows abnormal hyperintensity in both medial temporal lobes <img src='/img/arrows/WS.png'/> and right insular cortex <img src='/img/arrows/WO.png'/>. Imaging of limbic encephalitis mimics that of herpes encephalitis; however, patients with limbic encephalitis have a subacute presentation. Hemorrhage suggests herpes rather than limbic encephalitis.*
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*Coronal T2 MR in the same patient shows abnormal hyperintensity in both medial temporal lobes <img src='img/arrows/WS.png'/> and right insular cortex <img src='img/arrows/WO.png'/>. Imaging of limbic encephalitis mimics that of herpes encephalitis; however, patients with limbic encephalitis have a subacute presentation. Hemorrhage suggests herpes rather than limbic encephalitis.*
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*Axial FLAIR MR shows abnormal hyperintensity in the medial temporal lobes bilaterally, characteristic of limbic encephalitis, the most common paraneoplastic syndrome. Bilateral involvement is typical of limbic encephalitis.*
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