Stroke preceding autoimmune encephalitis with neuronal potassium channel antibody

Autoimmune encephalitis related to voltage-gated potassium channel (VGKC) antibodies can occur as a complication of cancer but, more frequently, as a non-paraneoplastic disorder. The prompt recognition and treatment could mitigate the morbidity associated with this entity, but the broad-spectrum of...

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Bibliographic Details
Published in:BMJ case reports 2012-05, Vol.2012 (may07 1), p.bcr0820114637-bcr0820114637
Main Authors: Simal, Patricia, Garcia-García, Ana Maria, Serna-Candel, Carmen, Egido, Jose Antonio
Format: Article
Language:English
Subjects:
Antibodies
Anticoagulants - therapeutic use
Antigens
Atrophy
Autoantibodies
Autoimmune diseases
Biomarkers
Blood-brain barrier
Bronchoscopy
Consciousness
Diagnosis, Differential
Electrocardiography
Electroencephalography
Encephalitis
Europe (West)
Fatal Outcome
Heparin - therapeutic use
Humans
Ischemia
Limbic Encephalitis - diagnosis
Limbic Encephalitis - etiology
Limbic Encephalitis - immunology
Limbic Encephalitis - therapy
Magnetic Resonance Imaging
Male
Medical imaging
Middle Aged
Paresis
Pneumonia
Polymerase Chain Reaction
Potassium
Potassium Channels, Voltage-Gated - immunology
Proteins
Stroke
Stroke - complications
Tomography, X-Ray Computed
Unusual Association of Diseases/Symptoms
White
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Description
Summary:Autoimmune encephalitis related to voltage-gated potassium channel (VGKC) antibodies can occur as a complication of cancer but, more frequently, as a non-paraneoplastic disorder. The prompt recognition and treatment could mitigate the morbidity associated with this entity, but the broad-spectrum of neurological manifestations often makes the diagnosis a challenge. The authors describe, here, a unique case of autoimmune encephalitis related to VGKC antibodies preceded by an ischaemic stroke. Conditions associated with the stroke (infection, seizures, metabolic disturbances) had delayed the diagnosis. The authors suggest that autoimmune encephalitis needs to be taken into consideration as part of a differential diagnosis in patients with prolonged encephalopathy following an ischaemic stroke. Infection may trigger an inflammatory response. In addition, the rupture of blood brain barrier that occurs in stroke may have a pathogenic role by allowing antibodies to gain access to the central nervous system.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr.08.2011.4637