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https://doi.org/10.3174/ajnr.A3633
Title: | MRI findings in autoimmune voltage-gated potassium channel complex encephalitis with seizures: One potential etiology for mesial temporal sclerosis | Authors: | Kotsenas, A.L Watson, R.E Pittock, S.J Britton, J.W Hoye, S.L Quek, A.M.L Shin, C Klein, C.J |
Keywords: | autoantibody voltage gated potassium channel adolescent adult aged article atrophy autoimmune disease autoimmune voltage gated potassium channel complex encephalitis child clinical article diffusion weighted imaging encephalitis female hippocampal sclerosis hippocampus human image analysis immunotherapy limbic cortex male middle aged nuclear magnetic resonance imaging retrospective study school child seizure serology statistical analysis temporal lobe young adult Adolescent Adult Aged Autoimmune Diseases Child Female Humans Limbic Encephalitis Magnetic Resonance Imaging Male Middle Aged Potassium Channels, Voltage-Gated Reproducibility of Results Sclerosis Sensitivity and Specificity Temporal Lobe Young Adult |
Issue Date: | 2014 | Publisher: | American Society of Neuroradiology | Citation: | Kotsenas, A.L, Watson, R.E, Pittock, S.J, Britton, J.W, Hoye, S.L, Quek, A.M.L, Shin, C, Klein, C.J (2014). MRI findings in autoimmune voltage-gated potassium channel complex encephalitis with seizures: One potential etiology for mesial temporal sclerosis. American Journal of Neuroradiology 35 (1) : 84-89. ScholarBank@NUS Repository. https://doi.org/10.3174/ajnr.A3633 | Rights: | Attribution 4.0 International | Abstract: | BACKGROUND AND PURPOSE: Autoimmune voltage-gated potassium channel complex encephalitis is a common form of autoimmune encephalitis. Patients with seizures due to this form of encephalitis commonly have medically intractable epilepsy and may require immunotherapy to control seizures. It is important that radiologists recognize imaging characteristics of this type of autoimmune encephalitis and suggest it in the differential diagnosis because this seizure etiology is likely under-recognized. Our purpose was to characterize MR imaging findings in this patient population. MATERIALS AND METHODS: MR imaging in 42 retrospectively identified patients (22 males; median age, 56 years; age range, 8-79 years) with seizures and voltage-gated potassium channel complex autoantibody seropositivity was evaluated for mesial and extratemporal swelling and/or atrophy, T2 hyperintensity, restricted diffusion, and enhancement. Statistical analysis was performed. RESULTS: Thirty-three of 42 patients (78.6%) demonstrated enlargement and T2 hyperintensity of mesial temporal lobe structures at some time point. Mesial temporal sclerosis was commonly identified (16/33, 48.5%) at follow-up imaging. Six of 9 patients (66.7%, P = .11) initially demonstrating hippocampal enhancement and 8/13 (61.5%, P = .013) showing hippocampal restricted diffusion progressed to mesial temporal sclerosis. Conversely, in 6 of 33 patients, abnormal imaging findings resolved. CONCLUSIONS: Autoimmune voltage-gated potassium channel complex encephalitis is frequently manifested as enlargement, T2 hyperintensity, enhancement, and restricted diffusion of the mesial temporal lobe structures in the acute phase. Recognition of these typical imaging findings may help prompt serologic diagnosis, preventing unnecessary invasive procedures and facilitating early institution of immunotherapy. Serial MR imaging may demonstrate resolution or progression of radiologic changes, including development of changes involving the contralateral side and frequent development of mesial temporal sclerosis. | Source Title: | American Journal of Neuroradiology | URI: | https://scholarbank.nus.edu.sg/handle/10635/183902 | ISSN: | 0195-6108 | DOI: | 10.3174/ajnr.A3633 | Rights: | Attribution 4.0 International |
Appears in Collections: | Staff Publications Elements |
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