Development from recurrent anti-N-methyl-D-aspartate receptor encephalitis with seizures as the first symptom to autoimmune-associated epilepsy: a case report

• 出版年: Acta Epileptologica
• 主要な著者: Ningxiang Qin, Jing Wang, Xi Peng, Liang Wang
• フォーマット: 論文
• 言語: 英語
• 出版事項: BMC 2023-07-01
• 主題: Anti-N-methyl-D-aspartate receptor encephalitis; Autoimmune-associated epilepsy; Seizure; Relapse; Case report
• オンライン･アクセス: https://doi.org/10.1186/s42494-023-00129-0

Abstract Background Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a novel autoimmune encephalitis (AE) first identified in 2007. It provides a new direction for clinicians when encountering unexplained symptoms such as seizures, psychotic behavioral abnormalities, speech disorders, and involuntary movements. Most patients have a good prognosis after immunotherapy, but some may experience relapses. Case presentation We report a Chinese female patient diagnosed with anti-NMDAR encephalitis. Over the past 30 years, the patient had experienced eight episodes with seizures as the first symptom, which eventually progressed to autoimmune-associated epilepsy. In the last two episodes, both serum and cerebrospinal fluid of the patient were negative for AE-related antibodies, and brain magnetic resonance imaging (MRI) revealed abnormal hyperintensity in the bilateral hippocampi. The patient's symptoms were poorly controlled by immunotherapy but well controlled by anti-seizure medicines. Conclusions Patients with a long history of AE and multiple relapses that start with seizures may display alterations of brain structure. Physicians should pay attention to autoimmune-associated epilepsy.