title: An immunologic case study of acute encephalitis with refractory, repetitive partial seizures.
abstract: Acute encephalitis with refractory, repetitive partial seizures (AERRPS) is a neurologic syndrome characterized by extraordinarily frequent and refractory partial seizures, which immediately evolve into refractory epilepsy. To elucidate the pathophysiology of AERRPS, we performed an immunologic study of an affected boy, revealing decreased natural killer (NK) cell activity in the peripheral blood mononuclear cells. IgG antibodies against the glutamate receptor (GluR)ε2, ζ1, and δ2 subunits were all positive in both the serum and cerebrospinal fluid (CSF). There were raised plasma concentrations of interleukin (IL)-2, IL-6, IL-10, tumor necrosis factor-α, and interferon-γ as well as an extremely elevated CSF level of IL-6. These findings suggest that AERRPS is immune-mediated encephalitis, in which both autoimmunity and exaggerated cytokine production are involved. NK cell dysfunction may be the underlying abnormality in this AERRPS case, which might have contributed to the production of GluR autoantibodies.
authors.affiliation: Department of Pediatrics, Ehime Prefectural Central Hospital, Ehime, Japan. hirwaka@hotmail.com
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Wakamoto
authors.forename: Yukitoshi
authors.initials: Y
authors.lastname: Takahashi
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Ebihara
authors.forename: Kentaro
authors.initials: K
authors.lastname: Okamoto
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Hayashi
authors.forename: Takashi
authors.initials: T
authors.lastname: Ichiyama
authors.forename: Eiichi
authors.initials: E
authors.lastname: Ishii
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001921:Brain / Q000473:pathology; D002648:Child; D016207:Cytokines / Q000097:blood; D004660:Encephalitis / Q000150:complications* / Q000276:immunology* / Q000473:pathology / Q000628:therapy; D004828:Epilepsies, Partial / Q000150:complications* / Q000276:immunology* / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use
chemical_list: D000893:Anti-Inflammatory Agents; D016207:Cytokines; D008775:Methylprednisolone