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New onset refractory convulsive status epilepticus (...)

Brain Dev. 2011 Sep ;33(8):687-91
New onset refractory convulsive status epilepticus associated with serum neuropil auto-antibodies in a school aged child.
Milh M, Villeneuve N, Chapon F, Gavaret M, Girard N, Mancini J, Chabrol B, Boucraut J.

We report a case of a child that suffered from a severe new onset status epilepticus a few days after a common viral infection. Despite extensive screening, no bacterial, viral or fungal infection could be found. Using immunohistochemical analysis, we found neuronal auto-antibodies directed against the neuropil, in blood and CSF, associated with CSF oligoclonal banding. Status epilepticus was highly refractory to antiepileptic drugs, but improved few days after Intra-Venous Immunoglobulin Injection (IVIG). The patient developed ongoing temporal lobe epilepsy that was still associated with neuropil auto-antibodies. Therefore, screening for antineuronal antibodies should be helpful to characterize and maybe to handle new onset status epilepticus without any obvious aetiology. Further studies should establish the link between epilepsy and such auto-antibodies.


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