Related Experiment Video

Updated: Jul 15, 2026

Electromagnetic Source Imaging in Presurgical Evaluation of Children with Drug-Resistant Epilepsy
09:57

Electromagnetic Source Imaging in Presurgical Evaluation of Children with Drug-Resistant Epilepsy

Published on: September 20, 2024

Refractory epilepsy accompanying acute encephalitis with multifocal cortical lesions: possible autoimmune etiology

Tohru Okanishi1, Yuka Mori, Tetsuya Kibe

  • 1Division of Child Neurology, Institute of Neurological Sciences, Faculty of Medicine, Tottori University, 36-1 Yonago 683-8504, Japan. oknsoknsokns@yahoo.co.jp

Brain & Development
|April 20, 2007
PubMed

Insights

This study details a teen with acute encephalitis and severe seizures (AERRPS), highlighting unusual brain lesions and long-term cognitive deficits. Treatment involved barbiturates, anti-epileptics, and resulted in intractable epilepsy.

Area of Science:

  • Neurology
  • Pediatric Neurology
  • Neuroimmunology

Background:

  • Acute encephalitis can present with severe neurological complications.
  • Acute encephalopathy with refractory, repetitive partial seizures (AERRPS) is a rare and severe condition.
  • Understanding the neuroimaging and immunological aspects of AERRPS is crucial for patient management.

Observation:

  • A 14-year-old male presented with acute encephalitis and extremely refractory seizures meeting AERRPS criteria.
  • The patient required prolonged mechanical ventilation and high-dose barbiturate therapy.
  • Neuroimaging revealed transient multifocal cortical lesions and later developed cerebral and hippocampal atrophy.

Findings:

  • Serum anti-glutamate receptor epsilon2 autoantibodies were detected early in the clinical course.
  • Seizures eventually improved with a combination of anti-epileptic drugs and sodium bromide.
  • The patient was discharged with intractable epilepsy, memory deficits, and intellectual regression.

Implications:

  • The presence of multifocal cortical lesions is an unusual neuroimaging finding in AERRPS.
  • Autoantibodies against glutamate receptors may play a role in the pathogenesis of AERRPS.
  • This case underscores the severe long-term neurological sequelae associated with AERRPS.

More Related Videos

Hippocampal Neuronal Cultures to Detect and Study New Pathogenic Antibodies Involved in Autoimmune Encephalitis08:20

Hippocampal Neuronal Cultures to Detect and Study New Pathogenic Antibodies Involved in Autoimmune Encephalitis

Published on: June 2, 2022

Related Concept Videos

Encephalitis l: Introduction01:19

Encephalitis l: Introduction

Encephalitis is inflammation of the brain parenchyma, most often due to infections or autoimmune processes. It presents with neuropsychiatric features such as fever, altered mental status, behavioral changes, cognitive dysfunction, seizures, focal deficits, and sometimes autonomic instability. In some cases, the meninges are also involved, resulting in meningoencephalitis.Infectious CausesInfectious encephalitis is most commonly viral but can also result from bacterial, fungal, or parasitic...
Encephalitis ll: Pathophysiology01:26

Encephalitis ll: Pathophysiology

Encephalitis is inflammation of the brain parenchyma caused by direct viral invasion or immune-mediated mechanisms triggered by infections or tumors. Both processes lead to neuronal injury, disrupted neurotransmission, and diverse neurological symptoms, often with overlapping clinical and pathological features.Autoimmune EncephalitisIn autoimmune encephalitis, antibodies target neuronal antigens on cell surfaces, synapses, or within neurons. A key example is anti-NMDAR encephalitis, which can...
Epilepsy ll: Types01:22

Epilepsy ll: Types

Recurrent seizures, stemming from abnormal electrical activity in the brain, are the defining characteristic of epilepsy, a chronic neurological condition. Because seizure features vary greatly, epilepsy is classified using two systems: by seizure type and by epilepsy syndromes. These classifications enable clinicians to describe seizure patterns and select suitable treatment strategies.I. Classification by Seizure Type1. Focal EpilepsyFocal epilepsy begins in one hemisphere of the brain.
Epilepsy and Seizures: Overview01:24

Epilepsy and Seizures: Overview

Epilepsy is a chronic neurological disease marked by recurrent, unpredictable seizures. These seizures are caused by abnormal electrical discharges in the brain, leading to behavior, sensation, or consciousness alterations. They can also cause transient impairment of awareness, interfering with daily activities.
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...
Seizures: Classification01:13

Seizures: Classification

Epilepsy is primarily characterized by unpredictable seizures, either provoked by an identifiable factor, such as injury or illness, or unprovoked, occurring spontaneously without apparent cause.
Seizures are typically classified into two main categories: focal and generalized seizures.
Focal Seizures
Focal seizures originate from specific regions of the brain. These seizures are further sub-classified into two types:
Seizures l: Introduction01:20

Seizures l: Introduction

Understanding seizures and epilepsy relies on key definitions that help in recognizing, classifying, and managing these disorders. These definitions provide a framework for recognizing, classifying, and managing seizure disorders.DefinitionsA seizure is a sudden, abnormal burst of electrical activity in the brain that can cause changes in awareness, movement, sensation, or behavior, depending on the area involved. Epilepsy is a chronic condition characterized by recurrent, unprovoked seizures,...