JLE

Epileptic Disorders

MENU

A case of anti-NMDA receptor encephalitis revealed by insular epilepsy Volume 19, numéro 4, December 2017

TEST YOURSELF

(1) What are the main semiological characteristics of insular epilepsy?

 

(2) What is the difference in clinical presentation between men and women suffering from NMDAR encephalitis?

 

(3) What tests should be performed to confirm the diagnosis of NMDAR encephalitis?

 

 

 

 

 

See answers

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Answers

(1) Sensitive symptoms distributed to a large cutaneous area without clear somatotopia or Jacksonian march, somato-sensitive symptoms ipsilateral to ictal discharge, and prolonged initial drooling without impairment of awareness.


(2) Adult men present more frequently with seizures than adult women. Female patients initially present abnormal behaviour and psychiatric symptoms. The inaugural seizures in men are frequently focal, while in women they are usually generalized.

 

(3) Paraclinical examinations, such as brain MRI, F18-FDG-PET, and EEG, can contribute to establishing the diagnosis, however, the diagnosis should be confirmed by the presence of antibodies directed against the NR1 subunit of the NMDA receptor in the cerebrospinal fluid; this test appears to be less specific when serum is used. Total-body PET-CT should finally be performed to exclude a paraneoplastic disorder.

 

 Back to questions