Please use this identifier to cite or link to this item: 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

Show full item record
Files in This Item:
File Description SizeFormatAccess SettingsVersion 
10_3174_ajnr_A3633.pdf999.28 kBAdobe PDF

OPEN

NoneView/Download

Google ScholarTM

Check

Altmetric


This item is licensed under a Creative Commons License Creative Commons