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Interictal High Frequency Oscillations Detected with Simultaneous Magnetoencephalography and Electroencephalography as Biomarker of Pediatric Epilepsy
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VGKC antibodies in pediatric encephalitis presenting with status epilepticus

J Suleiman1, T Brenner, D Gill

  • 1Children's Hospital at Westmead, Sydney 2145, Australia.

Neurology
|April 6, 2011
PubMed

Insights

Voltage-gated potassium channel antibodies (VGKC Ab) are linked to encephalitis in children, presenting with seizures. These VGKC Abs were not directed against Lgi1 or Caspr2 in this study.

Area of Science:

  • Neurology
  • Immunology
  • Pediatrics

Background:

  • Voltage-gated potassium channel antibodies (VGKC Ab) are known to cause limbic encephalitis and neuromyotonia in adults.
  • Systematic investigations of VGKC Ab in pediatric encephalitis are lacking.

Purpose of the Study:

  • To investigate the presence of VGKC Ab and other CNS-associated antibodies in children with unexplained encephalitis.
  • To characterize the clinical presentation and outcomes of pediatric encephalitis associated with VGKC Ab.

Main Methods:

  • Serum samples from 10 children with encephalitis, encephalopathy, and status epilepticus were tested for VGKC Ab, Lgi1 Ab, Caspr2 Ab, GAD Ab, NMDAR Ab, and GlyR Ab.
  • Pediatric controls (n=69) were used for comparison.

Main Results:

  • Elevated VGKC Ab (>100 pM) was detected in 40% (4/10) of pediatric encephalitis patients, significantly higher than in controls (1/69, p < 0.001).
  • Clinical outcomes in VGKC Ab-positive children varied, including cognitive impairment and epilepsy.
  • Antibodies to Lgi1 and Caspr2 were not detected in any of the patients.

Conclusions:

  • VGKC Ab-associated encephalitis occurs in children, often presenting with status epilepticus and focal epilepsy.
  • The identified VGKC Ab in pediatric encephalitis are not directed against Lgi1 or Caspr2.
Abstract

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