Electroclinical insights into autoimmune epilepsy.
J Neuroimmunol
; 330: 44-47, 2019 05 15.
Article
en En
| MEDLINE
| ID: mdl-30798192
PURPOSE: Chronic autoimmune epilepsy is an increasingly recognised entity however its clinical and electrographic features remain poorly understood. We present a case undergoing diagnostic Stereo-electroencephalography implantation that was found to have a multifocal perisylvian epilepsy with unique electrographic features and is now seizure free with immunotherapy. METHODS: The patient had antibody negative refractory perisylvian epilepsy and underwent implantation of the perisylvian-temporal networks. Immunomodulatory treatment was administered during SEEG. RESULTS: SEEG demonstrated a multifocal perisylvian epilepsy with strong involvement of the posterior insula. There was almost continuous spiking seen interictally from multiple foci within the right hemisphere and independent seizures were generated from 5 locations. After treatment with intravenous methylprednisone and immunoglobulin during SEEG, spiking and seizures terminated while still off anti-seizure medications. The patient remains seizure free on immunotherapy. CONCLUSION: This case highlights the importance of considering autoimmunity in the differential diagnosis of refractory epilepsy, especially perisylvian epilepsy. It also highlights the need to define a clinical phenotype associated with autoantibodies in epilepsy, as there are likely many cases who are not positive for one of the commercially available tests. This case also provides insights into the possible features of an electroclinical syndrome associated with autoimmunity.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Técnicas Estereotáxicas
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Enfermedades Autoinmunes del Sistema Nervioso
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Electroencefalografía
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Epilepsia
Límite:
Adult
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Female
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Humans
Idioma:
En
Revista:
J Neuroimmunol
Año:
2019
Tipo del documento:
Article
Pais de publicación:
Países Bajos