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• Vol.45 No.9
• CLINICA NEUROL, 45: 657−662, 2005
• Vol.45 No.9 contents

Case Report

A case of non-herpetic acute encephalitis with autoantibodies for ionotropic glutamate receptor δ2 and ε2

Yuichi Hayashi, M.D.¹⁾, Zenjiro Matsuyama, M.D.¹⁾, Yukitoshi Takahashi, M.D.²⁾, Kenji Wakida, M.D.¹⁾, Tatsuma Hashizume, M.D.¹⁾, Akio Kimura, M.D.¹⁾, Isao Hozumi, M.D.¹⁾, Masahiko Murase, M.D.³⁾ and Takashi Inuzuka, M.D.¹⁾

¹⁾Department of Neurology and Geriatrics, Division of Neuroscience, Gifu University Graduate School of Medicine
²⁾National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders
³⁾Department of Neurology, Hashima City Hospital

We report a 45-year-old woman admitted to our hospital due to fever, consciousness disturbance, and severe seizures. Based on her sings and symptoms and clinical course, a diagnosis of non-herpetic acute encephalitis was made. She received antibiotic drugs, acyclovir, γ-globulin, and steroid pulse therapy (methylprednisolone 1 g/day, 3 days). The patient's signs, symptoms and severe seizure showed marked improvement, but she still showed monthly seizure attacks and both anterograde and retrograde amnesia.
Viral infection and autoimmune response after viral infection may have been involved in non-herpetic acute encephalitis in our patient. Recently, autoantibodies to GluRε2 and VGKC were reported in cases of non-herpetic acute limbic encephalitis (NHALE). In our patient, we detected IgM type autoantibody to GluRδ 2 and ε2 in both the CSF and serum, and these antibodies normalized in the CSF with the clinical course. Autoantibodies to GluRδ2 and ε2 may be involved in the clinical symptoms and pathogenesis of non herpetic acute limbic encephalitis. This is the first report of MRI-positive non-herpetic acute encephalitis with autoantibodies to GluRδ2 and ε2.

(CLINICA NEUROL, 45: 657−662, 2005)
key words: anti-GluRδ2 antibody, anti-GluRε2 antibody, limbic encephalitis, seizure, steroid pulse therapy

(Received: 4-Nov-04)