Four cases of gabab receptor encephalitis

Monika Szots, M. Blaabjerg, D Kondziella, M. Herceg, P Dioszeghy, Gábor Bajzik, T Berki, E. Kalman, Ferenc Nagy, Z. Illes

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

GABAb receptor (gamma- Aminobutyric acid type B receptors - GABAbR) encephalitis is a rare manifestation of autoimmune encephalitides. We report four cases - including the first 1wo Hungarian patients - with some peculiar features. One patient developed subacute disorientation and almost complete loss of short-term memory, but no epilepsy. Without immunotherapy, his memory spontaneously improved up to mild cognitive impairment in six weeks. GABAbR antibodies persisted in his serum, and 18 months later, FDG-PET detected abnormal mediastinal lymph nodes and small cell lung cancer (SCLC). Another patient had persistently decreased sodium content in the peripheral blood. In those three patients who died, CSF was abnormal, but CSF was not pathological in the patient, who spontaneously improved. Brain MRI indicated signal intensity changes in the medial temporal areas in three cases. SCLC was found in three patients. Only the patient, who spontaneously improved, survived for more than 24 months. In summary, our cases show that (i) GABAbR encephalitis may develop without epilepsy; (ii) the severe short-term memory loss can spontaneously improve; (iii) persistent hyponatremia can be present in the blood; (iv) the patient with benign course without epilepsy and CSF abnormality survived; (v) spontaneously remitting encephalitis can precede SCLC by 1.5 year, which emphasizes that repeated search for cancer is of paramount importance even in cases with spontaneous improvement.
Original languageEnglish
JournalIdeggyogyaszati Szemle
Volume69
Issue number7-8
Pages (from-to)281-287
ISSN0019-1442
DOIs
Publication statusPublished - 2016

Cite this

Szots, M., Blaabjerg, M., Kondziella, D., Herceg, M., Dioszeghy, P., Bajzik, G., ... Illes, Z. (2016). Four cases of gabab receptor encephalitis. Ideggyogyaszati Szemle, 69(7-8), 281-287. https://doi.org/10.18071/isz.69.0281
Szots, Monika ; Blaabjerg, M. ; Kondziella, D ; Herceg, M. ; Dioszeghy, P ; Bajzik, Gábor ; Berki, T ; Kalman, E. ; Nagy, Ferenc ; Illes, Z. / Four cases of gabab receptor encephalitis. In: Ideggyogyaszati Szemle. 2016 ; Vol. 69, No. 7-8. pp. 281-287.
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Szots, M, Blaabjerg, M, Kondziella, D, Herceg, M, Dioszeghy, P, Bajzik, G, Berki, T, Kalman, E, Nagy, F & Illes, Z 2016, 'Four cases of gabab receptor encephalitis', Ideggyogyaszati Szemle, vol. 69, no. 7-8, pp. 281-287. https://doi.org/10.18071/isz.69.0281

Four cases of gabab receptor encephalitis. / Szots, Monika; Blaabjerg, M.; Kondziella, D; Herceg, M.; Dioszeghy, P; Bajzik, Gábor; Berki, T; Kalman, E.; Nagy, Ferenc; Illes, Z.

In: Ideggyogyaszati Szemle, Vol. 69, No. 7-8, 2016, p. 281-287.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Four cases of gabab receptor encephalitis

AU - Szots, Monika

AU - Blaabjerg, M.

AU - Kondziella, D

AU - Herceg, M.

AU - Dioszeghy, P

AU - Bajzik, Gábor

AU - Berki, T

AU - Kalman, E.

AU - Nagy, Ferenc

AU - Illes, Z.

PY - 2016

Y1 - 2016

N2 - GABAb receptor (gamma- Aminobutyric acid type B receptors - GABAbR) encephalitis is a rare manifestation of autoimmune encephalitides. We report four cases - including the first 1wo Hungarian patients - with some peculiar features. One patient developed subacute disorientation and almost complete loss of short-term memory, but no epilepsy. Without immunotherapy, his memory spontaneously improved up to mild cognitive impairment in six weeks. GABAbR antibodies persisted in his serum, and 18 months later, FDG-PET detected abnormal mediastinal lymph nodes and small cell lung cancer (SCLC). Another patient had persistently decreased sodium content in the peripheral blood. In those three patients who died, CSF was abnormal, but CSF was not pathological in the patient, who spontaneously improved. Brain MRI indicated signal intensity changes in the medial temporal areas in three cases. SCLC was found in three patients. Only the patient, who spontaneously improved, survived for more than 24 months. In summary, our cases show that (i) GABAbR encephalitis may develop without epilepsy; (ii) the severe short-term memory loss can spontaneously improve; (iii) persistent hyponatremia can be present in the blood; (iv) the patient with benign course without epilepsy and CSF abnormality survived; (v) spontaneously remitting encephalitis can precede SCLC by 1.5 year, which emphasizes that repeated search for cancer is of paramount importance even in cases with spontaneous improvement.

AB - GABAb receptor (gamma- Aminobutyric acid type B receptors - GABAbR) encephalitis is a rare manifestation of autoimmune encephalitides. We report four cases - including the first 1wo Hungarian patients - with some peculiar features. One patient developed subacute disorientation and almost complete loss of short-term memory, but no epilepsy. Without immunotherapy, his memory spontaneously improved up to mild cognitive impairment in six weeks. GABAbR antibodies persisted in his serum, and 18 months later, FDG-PET detected abnormal mediastinal lymph nodes and small cell lung cancer (SCLC). Another patient had persistently decreased sodium content in the peripheral blood. In those three patients who died, CSF was abnormal, but CSF was not pathological in the patient, who spontaneously improved. Brain MRI indicated signal intensity changes in the medial temporal areas in three cases. SCLC was found in three patients. Only the patient, who spontaneously improved, survived for more than 24 months. In summary, our cases show that (i) GABAbR encephalitis may develop without epilepsy; (ii) the severe short-term memory loss can spontaneously improve; (iii) persistent hyponatremia can be present in the blood; (iv) the patient with benign course without epilepsy and CSF abnormality survived; (v) spontaneously remitting encephalitis can precede SCLC by 1.5 year, which emphasizes that repeated search for cancer is of paramount importance even in cases with spontaneous improvement.

U2 - 10.18071/isz.69.0281

DO - 10.18071/isz.69.0281

M3 - Journal article

VL - 69

SP - 281

EP - 287

JO - Ideggyogyaszati Szemle

JF - Ideggyogyaszati Szemle

SN - 0019-1442

IS - 7-8

ER -

Szots M, Blaabjerg M, Kondziella D, Herceg M, Dioszeghy P, Bajzik G et al. Four cases of gabab receptor encephalitis. Ideggyogyaszati Szemle. 2016;69(7-8):281-287. https://doi.org/10.18071/isz.69.0281