Rinsho Shinkeigaku (Clinical Neurology)

Case Report

GABAB receptor autoimmune encephalitis presenting as transient epileptic amnesia

Satoko Oagawa, M.D.1), Yuto Uchida, M.D., Ph.D.1)2), Shin Kobayashi, M.D.3), Koji Takada, M.D., Ph.D.1), Kiyohito Terada, M.D., Ph.D.4)5) and Noriyuki Matsukawa, M.D., Ph.D.2)

1) Department of Neurology, Toyokawa City Hospital
2) Department of Neurology, Nagoya City University Graduate School of Medical Sciences
3) Department of Radiology, Toyokawa City Hospital
4) Department of Neurology, National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders
5) Yokohama Minoru Epilepsy & Developmental Clinic

This case was a 50-year-old healthy woman. After repeated transient amnesia, she developed tonic-clonic seizures and was admitted to our hospital. The brain MRI showed FLAIR hyperintensities in the left temporal lobe and EEG showed an epileptic discharge starting from the left temporal region. Based on these findings, we diagnosed temporal lobe epilepsy associated with acute limbic encephalitis. While she experienced recurrent transient amnesia, her cognitive functions were preserved except for her memory. These symptoms and EEG findings were consistent with transient epileptic amnesia (TEA). Acute limbic encephalitis that occurred in a healthy middle-aged woman may be antibody-mediated encephalitis, requiring immediate immunotherapies. In this case, GABAB receptor antibodies in cerebrospinal fluid were found positive. This is the first report showing that TEA was caused by GABAB receptor autoimmune encephalitis.
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(CLINICA NEUROL, 61: 6|11, 2021)
key words: transient epileptic amnesia, GABAB receptor antibody, autoimmune encephalitis

(Received: 9-Feb-20)