Autoimmune encephalopathy and drug refractory seizures with the presence of two autoantibodies specific for the neuronal cell surface

Abstract

Background: An increasing number of autoantibodies are being described in epilepsy and other seizure-related disorders. A pathogenic role of autoantibodies in epilepsy has been suggested based on observations of the efficacy of immunotherapy. Objective: This study aimed to report a new case of autoimmune-mediated encephalopathy and seizures caused by autoantibodies to voltage-gated potassium channels (VGKCs) and voltage-gated calcium channels (VGCCs) (P/Q-type) and the response to immunotherapy. Design: This study follows a case report design. Setting: This study was conducted in a tertiary care center. Patients: Our patient was an eighteen-year-old female with new-onset encephalopathy and refractory seizures. Intervention: Our patient was treated for five days with intravenous methylprednisolone (IVMP) and intravenous immunoglobulin (IVIG). Results: After treatment with IVMP and IVIG, our patient showed significant clinical improvement and did not exhibit any seizures during the one-month follow-up period. Conclusions: Here, we report a rare case of an autoimmune encephalopathy and seizures associated with the presence of two surface neuronal autoantibodies. This report highlights the importance of early diagnosis of autoimmune epilepsy, as early immunomodulating treatments improve the outcome.

Keywords

• Autoimmune-mediated encephalopathy
• Autoantibodies
• Voltage-gated potassium channels (VGKCs)
• Voltage-gated calcium channels (VGCCs) (P/Q-type)
• Immunotherapy