title: Extratemporal EEG and MRI findings in ANNA-1 (anti-Hu) encephalitis.
abstract: BACKGROUND
  Extratemporal involvement has been reported in ANNA-1 encephalitis, but the rate is unknown. EEG and MRI are used in the evaluation of these patients, but the relative value of each has not been determined. The study objectives were to measure the rate of extratemporal abnormalities, and to determine the relative value of MRI and EEG in an ANNA-1 encephalitis cohort.
  
  
  METHODS
  We selected from the neuroimmunology laboratory database ANNA-1 seropositive patients who underwent: (1) neurological evaluation at Mayo Clinic Rochester between 1990 and 2010 (2) comprehensive autoimmune paraneoplastic serological evaluation and (3) at least one EEG and MRI.
  
  
  RESULTS
  Of 28 identified patients, the EEG was abnormal in 24 (86%). Extratemporal abnormalities included slowing [12 (43%)], epileptiform discharges [eight (29%)], and epilepsia partialis continua [two (7%)]. In ten patients, only the MRI or EEG showed an abnormality but not both. Six patients had focal EEG abnormalities localized to regions other than those on MRI. In 13 patients with a negative MRI, the EEG showed a focal abnormality in seven (54%).
  
  
  CONCLUSIONS
  Extratemporal EEG abnormalities are present in nearly half of ANNA-1 seropositive patients, suggesting that extratemporal involvement is common. EEG and MRI are often complementary in determining lesional distribution in ANNA-1 seropositive patients.
authors.affiliation: Department of Neurology, Mayo Clinic College of Medicine, 200 First St. SW, Rochester, MN 55905, USA. leslie.a.rudzinski@emory.edu
authors.forename: Leslie A
authors.initials: LA
authors.lastname: Rudzinski
authors.forename: Sean J
authors.initials: SJ
authors.lastname: Pittock
authors.forename: Andrew
authors.initials: A
authors.lastname: McKeon
authors.forename: Vanda A
authors.initials: VA
authors.lastname: Lennon
authors.forename: Jeffrey W
authors.initials: JW
authors.lastname: Britton
mesh_terms: D051959:ELAV Proteins / Q000276:immunology*; D004569:Electroencephalography; D004660:Encephalitis / Q000097:blood / Q000473:pathology / Q000503:physiopathology; D004827:Epilepsy / Q000209:etiology / Q000473:pathology; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D008279:Magnetic Resonance Imaging; D008297:Male; D012189:Retrospective Studies; D013702:Temporal Lobe / Q000473:pathology* / Q000503:physiopathology*
chemical_list: D051959:ELAV Proteins; D007074:Immunoglobulin G