John Libbey Eurotext

Epileptic Disorders

The Educational Journal of the International League Against Epilepsy

Serial EEG findings in anti-NMDA receptor encephalitis: correlation between clinical course and EEG Volume 19, numéro 4, December 2017

Illustrations

  • Figure 1
  • Figure 2
Auteurs
1 Department of Neurology, Kobe City Medical Centre General Hospital, 2-1-1, Minatojimaminamimachi, Chuo-ku, Kobe city 650-0047
2 Department of Neurology, Kyoto University Graduate School of Medicine, 54, Kawaramachi, Sakyo-ku, Kyoto city 606-8507, Japan
* Correspondence: Jun Ueda Department of Neurology, Kobe City Medical Centre General Hospital, 2-1-1, Minatojimaminamimachi, Chuo-ku, Kobe city 650-0047, Japan
  • Mots-clés : autoimmune encephalitis, extreme delta brush, N-methyl-D-aspartate receptor
  • DOI : 10.1684/epd.2017.0942
  • Page(s) : 465-70
  • Année de parution : 2017

Anti-NMDA receptor encephalitis is a paraneoplastic encephalitis characterised by psychiatric features, involuntary movement, and autonomic instability. Various EEG findings in patients with anti-NMDA receptor encephalitis have been reported, however, the correlation between the EEG findings and clinical course of anti-NMDA receptor encephalitis remains unclear. We describe a patient with anti-NMDA receptor encephalitis with a focus on EEG findings, which included: status epilepticus, generalised rhythmic delta activity, excess beta activity, extreme delta brush, and paroxysmal alpha activity upon arousal from sleep, which we term“arousal alpha pattern”. Initially, status epilepticus was observed on the EEG when the patient was comatose with conjugate deviation. The EEG then indicated excess beta activity, followed by the emergence of continuous slow activity, including generalised rhythmic delta activity and extreme delta brush, in the most severe phase. Slow activity gradually faded in parallel with clinical amelioration. Excess beta activity persisted, even after the patient became almost independent in daily activities, and finally disappeared with full recovery. In summary, our patient with anti-NMDA receptor encephalitis demonstrated slow activity on the EEG, including extreme delta brush during the most severe phase, which gradually faded in parallel with clinical amelioration, with excess beta activity persisting into the recovery phase.