Adult-onset drug-refractory seizure disorder associated with anti-voltage-gated potassium-channel antibody.
Voltage-gated potassium channels are widely expressed throughout the entire nervous system. These channels play a critical role in establishing the resting membrane potential and generation of neuronal action potentials. There is mounting evidence that autoantibodies reactive to neuronal cell surface antigens, such as voltage-gated potassium channels, play a pathogenic role in a wide spectrum of central and peripheral nervous system disorders. We report a case of new-onset drug-refractory seizure disorder associated with the presence of high levels of serum anti-voltage-gated potassium channel antibodies that responded only to immunotherapy. As demonstrated by this case report, anti-voltage-gated potassium channel antibody associated drug-refractory seizure disorder, although rare, should be considered in patients with unexplained adult-onset seizure activity. Once the diagnosis has been established the initiation of immunotherapy should be undertaken without delay.
Department of Radiology, Neuroradiology Section, University of California, San Francisco, California 94143-1207, USA.
Ramon F
RF
Barajas
D Eric
DE
Collins
Soonmee
S
Cha
Michael D
MD
Geschwind
D000200:Action Potentials / Q000276:immunology / Q000502:physiology; D017668:Age of Onset; D000927:Anticonvulsants / Q000627:therapeutic use; D001323:Autoantibodies / Q000276:immunology*; D004351:Drug Resistance; D004569:Electroencephalography / Q000706:statistics & numerical data; D004827:Epilepsy / Q000188:drug therapy / Q000276:immunology* / Q000503:physiopathology*; D004833:Epilepsy, Temporal Lobe / Q000276:immunology / Q000503:physiopathology / Q000628:therapy; D005500:Follow-Up Studies; D006624:Hippocampus / Q000276:immunology / Q000503:physiopathology; D006801:Humans; D007167:Immunotherapy / Q000379:methods; D020363:Limbic Encephalitis / Q000175:diagnosis / Q000276:immunology* / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008564:Membrane Potentials / Q000276:immunology / Q000502:physiology; D008875:Middle Aged; D009474:Neurons / Q000276:immunology; D024642:Potassium Channels, Voltage-Gated / Q000276:immunology* / Q000502:physiology
D000927:Anticonvulsants; D001323:Autoantibodies; D024642:Potassium Channels, Voltage-Gated