Apical Ballooning Resulting from Limbic Encephalitis

Jill Gelow, Michael Kruer, Vijayshree Yadav, Sanjiv Kaul

Research output: Contribution to journalArticlepeer-review

26 Scopus citations


Background: Neurogenic stunned myocardium is an increasingly recognized cause of left ventricular apical ballooning, or takotsubo cardiomyopathy. We report the first case of neurogenic stunned myocardium as a result of limbic encephalitis. Methods: This 73-year-old woman with anterograde and retrograde amnesia was investigated using electrocardiography, magnetic resonance imaging, and left ventricular angiography. Results: Electrocardiography showed deep T-wave inversions in multiple leads, magnetic resonance imaging demonstrated increased signal on fluid-attenuated inversion recovery images symmetrically within the medial temporal lobes consistent with limbic encephalitis. Left ventricular angiography showed apical ballooning. Conclusions: Because the insula has extensive interconnections with limbic structures, limbic encephalitis could lead to alterations in the sympathetic regulation of the insular cortex resulting in neurogenic stunned myocardium.

Original languageEnglish (US)
Pages (from-to)583-586
Number of pages4
JournalAmerican Journal of Medicine
Issue number6
StatePublished - Jun 2009


  • Apical ballooning
  • Limbic encephalitis
  • Stunned myocardium

ASJC Scopus subject areas

  • Medicine(all)


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