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Isolated subtle asymmetric slowing on EEG leading to a diagnosis of autoimmune encephalitis
The Egyptian Journal of Neurology, Psychiatry and Neurosurgery Pub Date : 2020-05-24 , DOI: 10.1186/s41983-020-00180-5
Belal Aldabbour , Khalid El-Salem , Suha Aqaileh , Deema Obiedat , Mohammad Qasaimeh , Majdi Al Qawasmeh , Abdel-Hameed Al-Mistarehi , Ahmed Yassin

Background Autoimmune encephalitis presents with subacute neurological, psychiatric, and behavioral symptoms. In many cases, MRI and CSF studies return normal. Laboratory testing for pathogenic neuronal antibodies is limited by accessibility and sensitivity issues. Finally, the different diagnostic approaches lack consensus and have until recently been largely retrospective. Collectively, these factors predispose for delays in diagnosis and treatment in many cases. Case presentation We describe the case of a 42-year-old woman who did not initially meet the newly proposed criteria for probable autoimmune encephalitis, but in whom the detection on electroencephalogram (EEG) of subtle asymmetric slowing of the left hemisphere ultimately led to the diagnosis. Discussion EEG is highly sensitive and rarely normal in encephalitis. The recently introduced diagnostic criteria for autoimmune encephalitis included new-onset seizures in the earliest steps in the algorithm but did not yet incorporate EEG findings. We encourage practicing physicians to use EEG as an early, sensitive diagnostic tool for cases suspected to have autoimmune encephalitis.

中文翻译:

脑电图上孤立的细微不对称减慢导致自身免疫性脑炎的诊断

背景自身免疫性脑炎表现为亚急性神经、精神和行为症状。在许多情况下,MRI 和 CSF 研究恢复正常。致病性神经元抗体的实验室检测受到可及性和敏感性问题的限制。最后,不同的诊断方法缺乏共识,并且直到最近才主要是回顾性的。总的来说,在许多情况下,这些因素易于延误诊断和治疗。案例介绍 我们描述了一个 42 岁女性的案例,她最初不符合新提出的可能的自身免疫性脑炎的标准,但在脑电图 (EEG) 上检测到左半球的细微不对称减慢最终导致诊断。讨论 EEG 高度敏感,在脑炎中很少正常。最近引入的自身免疫性脑炎诊断标准在算法的最早步骤中包括新发癫痫发作,但尚未纳入 EEG 发现。我们鼓励执业医师将脑电图用作疑似自身免疫性脑炎病例的早期、敏感诊断工具。
更新日期:2020-05-24
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