S Jeannin-Mayer1, N André-Obadia2, S Rosenberg3, C Boutet4, J Honnorat5, J C Antoine6, L Mazzola7. 1. Department of Neurology, University Hospital Center of Saint-Etienne, France. Electronic address: sophiejeannin@icloud.com. 2. Department of Functional Neurology and Epileptology, Hospital for Neurology and Neurosurgery Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France; NeuroPain Lab, Lyon Neuroscience Research Centre, CRNL-InsermU 1028/CNRS UMR5292, University of Lyon, France. Electronic address: nathalie.obadia-andre@chu-lyon.fr. 3. Department of Neurology and Clinical Neurophysiology, University Hospital of Clermont-Ferrand, France. Electronic address: drosenberg@chu-clermontferrand.fr. 4. Radiology Department, University Hospital Center of Saint-Etienne, France. Electronic address: claire.boutet@chu-st-etienne.fr. 5. Institut NeuroMyogène, Equipe Synaptopathies et Autoanticorps (SynatAc), INSERM U1217/UMR CRS 5310, University of Lyon, France; French Reference Center on Paraneoplastic Neurological Syndrome, Hospices Civils de Lyon, France. Electronic address: jerome.honnorat@chu-lyon.fr. 6. Department of Neurology, University Hospital Center of Saint-Etienne, France. Electronic address: j.christophe.antoine@chu-st-etienne.fr. 7. Department of Neurology, University Hospital Center of Saint-Etienne, France; NeuroPain Lab, Lyon Neuroscience Research Centre, CRNL-InsermU 1028/CNRS UMR5292, University of Lyon, France. Electronic address: lauremazzola@yahoo.fr.
Abstract
OBJECTIVE: To describe different electroencephalogram (EEG) patterns and epileptic features in patients with anti-N-methyl-D-aspartate receptor encephalitis (anti-NMDARE), their timeline in the course of the disease, their correlation with clinical data and outcome. METHODS: We retrospectively analyzed EEG recordings between November 2007 and June 2016 in 24 consecutive patients. RESULTS: Three EEG patterns were described: Excessive Beta Activity range 14-20 Hz (EBA) in 71% of patients, Extreme Delta Brush (EDB) in 58% and Generalized Rhythmic Delta Activity (GRDA) in 50%. They followed a chronological organization in the course of the disease: EBA appeared first, followed by EDB and then GRDA, as the median time of appearance for EBA, EDB and GRDA was respectively 10, 16.5 and 21.5 days. The presence of GRDA was strongly associated with concomitant abnormal movements (p < 0.001). CONCLUSION: This study focuses on EEG and epileptic abnormalities in anti-NMDARE. Beyond EDB that were already reported (Schmitt et al., 2012), GRDA seems to be a very frequent pattern. Its rhythmic aspect should not be misinterpreted as seizure or status epilepticus, to avoid antiepileptic treatments intensification. SIGNIFICANCE: This study comforts the importance of EEG in anti-NMDARE, with a better description of EEG abnormalities for a better treatment management.
OBJECTIVE: To describe different electroencephalogram (EEG) patterns and epileptic features in patients with anti-N-methyl-D-aspartate receptor encephalitis (anti-NMDARE), their timeline in the course of the disease, their correlation with clinical data and outcome. METHODS: We retrospectively analyzed EEG recordings between November 2007 and June 2016 in 24 consecutive patients. RESULTS: Three EEG patterns were described: Excessive Beta Activity range 14-20 Hz (EBA) in 71% of patients, Extreme Delta Brush (EDB) in 58% and Generalized Rhythmic Delta Activity (GRDA) in 50%. They followed a chronological organization in the course of the disease: EBA appeared first, followed by EDB and then GRDA, as the median time of appearance for EBA, EDB and GRDA was respectively 10, 16.5 and 21.5 days. The presence of GRDA was strongly associated with concomitant abnormal movements (p < 0.001). CONCLUSION: This study focuses on EEG and epileptic abnormalities in anti-NMDARE. Beyond EDB that were already reported (Schmitt et al., 2012), GRDA seems to be a very frequent pattern. Its rhythmic aspect should not be misinterpreted as seizure or status epilepticus, to avoid antiepileptic treatments intensification. SIGNIFICANCE: This study comforts the importance of EEG in anti-NMDARE, with a better description of EEG abnormalities for a better treatment management.
Authors: Sukhvir K Wright; Richard E Rosch; Max A Wilson; Manoj A Upadhya; Divya R Dhangar; Charlie Clarke-Bland; Tamara T Wahid; Sumanta Barman; Norbert Goebels; Jakob Kreye; Harald Prüss; Leslie Jacobson; Danielle S Bassett; Angela Vincent; Stuart D Greenhill; Gavin L Woodhall Journal: Commun Biol Date: 2021-09-20