Evidence map›Paper›PMID 37202183›Full record

ArticleNeurology(R) neuroimmunology & neuroinflammation2023

Anti-GABA-A Receptor Antibody-Mediated Epilepsia Partialis Continua After Treatment With Alemtuzumab: A Case Report.

Dominica Ratuszny, Thomas Skripuletz, Thomas Stüber, Emil Valizada, Klaus Gehring, Philipp Ertl, Jörg Andreas Müller, Mike P Wattjes, Friedrich Feuerhake, Kurt-Wolfram Sühs

Open access · goldAbstract readCase Reports
PubMed Full text at PMC Publisher
In one paragraph

Article in Neurology(R) neuroimmunology & neuroinflammation, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.0field-weighted citation impact, top 23% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 5 citations in OpenAlex.

  1. Autoimmune Encephalitis in Acute Care-Pathology, Diagnosis, and Management.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2026
    Review
  2. Review
  3. Recent advances in autoimmune encephalitis.Arquivos de neuro-psiquiatria · 2024
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 1 institution in 2 countries.

Dominica RatusznyFrom the Department of Neurology (D.R., T. Skripuletz, E.V., K.-W.S.); Clinic for Anesthesiology and Intensive Care (T. Stüber), Hannover Medical School; Outpatient Clinic of Neurology (K.G.), Neurozentrum, Itzehoe; Departments of Neurosurgery (P.E.), Nuclear Medicine (J.A.M.), Diagnostic and Interventional Neuroradiology (M.P.W.), and Neuropathology (F.F.), Institute of Pathology, Hannover Medical School, Germany. ratuszny.dominica@mh-hannover.de.
Thomas SkripuletzFrom the Department of Neurology (D.R., T. Skripuletz, E.V., K.-W.S.); Clinic for Anesthesiology and Intensive Care (T. Stüber), Hannover Medical School; Outpatient Clinic of Neurology (K.G.), Neurozentrum, Itzehoe; Departments of Neurosurgery (P.E.), Nuclear Medicine (J.A.M.), Diagnostic and Interventional Neuroradiology (M.P.W.), and Neuropathology (F.F.), Institute of Pathology, Hannover Medical School, Germany.ORCID 0000-0001-8550-335X
Thomas StüberFrom the Department of Neurology (D.R., T. Skripuletz, E.V., K.-W.S.); Clinic for Anesthesiology and Intensive Care (T. Stüber), Hannover Medical School; Outpatient Clinic of Neurology (K.G.), Neurozentrum, Itzehoe; Departments of Neurosurgery (P.E.), Nuclear Medicine (J.A.M.), Diagnostic and Interventional Neuroradiology (M.P.W.), and Neuropathology (F.F.), Institute of Pathology, Hannover Medical School, Germany.
Emil ValizadaFrom the Department of Neurology (D.R., T. Skripuletz, E.V., K.-W.S.); Clinic for Anesthesiology and Intensive Care (T. Stüber), Hannover Medical School; Outpatient Clinic of Neurology (K.G.), Neurozentrum, Itzehoe; Departments of Neurosurgery (P.E.), Nuclear Medicine (J.A.M.), Diagnostic and Interventional Neuroradiology (M.P.W.), and Neuropathology (F.F.), Institute of Pathology, Hannover Medical School, Germany.
Klaus GehringFrom the Department of Neurology (D.R., T. Skripuletz, E.V., K.-W.S.); Clinic for Anesthesiology and Intensive Care (T. Stüber), Hannover Medical School; Outpatient Clinic of Neurology (K.G.), Neurozentrum, Itzehoe; Departments of Neurosurgery (P.E.), Nuclear Medicine (J.A.M.), Diagnostic and Interventional Neuroradiology (M.P.W.), and Neuropathology (F.F.), Institute of Pathology, Hannover Medical School, Germany.
Philipp ErtlFrom the Department of Neurology (D.R., T. Skripuletz, E.V., K.-W.S.); Clinic for Anesthesiology and Intensive Care (T. Stüber), Hannover Medical School; Outpatient Clinic of Neurology (K.G.), Neurozentrum, Itzehoe; Departments of Neurosurgery (P.E.), Nuclear Medicine (J.A.M.), Diagnostic and Interventional Neuroradiology (M.P.W.), and Neuropathology (F.F.), Institute of Pathology, Hannover Medical School, Germany.
Jörg Andreas MüllerFrom the Department of Neurology (D.R., T. Skripuletz, E.V., K.-W.S.); Clinic for Anesthesiology and Intensive Care (T. Stüber), Hannover Medical School; Outpatient Clinic of Neurology (K.G.), Neurozentrum, Itzehoe; Departments of Neurosurgery (P.E.), Nuclear Medicine (J.A.M.), Diagnostic and Interventional Neuroradiology (M.P.W.), and Neuropathology (F.F.), Institute of Pathology, Hannover Medical School, Germany.
Mike P WattjesFrom the Department of Neurology (D.R., T. Skripuletz, E.V., K.-W.S.); Clinic for Anesthesiology and Intensive Care (T. Stüber), Hannover Medical School; Outpatient Clinic of Neurology (K.G.), Neurozentrum, Itzehoe; Departments of Neurosurgery (P.E.), Nuclear Medicine (J.A.M.), Diagnostic and Interventional Neuroradiology (M.P.W.), and Neuropathology (F.F.), Institute of Pathology, Hannover Medical School, Germany.
Friedrich FeuerhakeFrom the Department of Neurology (D.R., T. Skripuletz, E.V., K.-W.S.); Clinic for Anesthesiology and Intensive Care (T. Stüber), Hannover Medical School; Outpatient Clinic of Neurology (K.G.), Neurozentrum, Itzehoe; Departments of Neurosurgery (P.E.), Nuclear Medicine (J.A.M.), Diagnostic and Interventional Neuroradiology (M.P.W.), and Neuropathology (F.F.), Institute of Pathology, Hannover Medical School, Germany.
Kurt-Wolfram SühsFrom the Department of Neurology (D.R., T. Skripuletz, E.V., K.-W.S.); Clinic for Anesthesiology and Intensive Care (T. Stüber), Hannover Medical School; Outpatient Clinic of Neurology (K.G.), Neurozentrum, Itzehoe; Departments of Neurosurgery (P.E.), Nuclear Medicine (J.A.M.), Diagnostic and Interventional Neuroradiology (M.P.W.), and Neuropathology (F.F.), Institute of Pathology, Hannover Medical School, Germany.
Klinikum Itzehoe · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesPatients with anti-GABA-A receptor encephalitis characteristically experience therapy-refractory epileptic seizures. General anesthesia is often required to terminate refractory status epilepticus. The immunologic mechanisms leading to antibody formation remain to be elucidated. Described triggers of anti-GABA-A autoimmunity are tumors, mainly thymomas, and herpes simplex encephalitis.

methodsWe present a young woman with prediagnosis of relapse remitting multiple sclerosis (MS), treated with interferons, natalizumab, and alemtuzumab. Six months after one and only cycle of alemtuzumab, speech arrest and behavioral changes with aggressive and anxious traits appeared. She showed increasing motor convulsions resulting in focal status epilepticus.

resultsAnti-GABA-A receptor antibodies in CSF and serum were confirmed in different external laboratories, in a more extensive analysis after antibodies against NMDAR, CASPR2, LGI1, GABABR, and AMPAR were ruled out during in-house examination. Clinical condition improved temporarily with cortisone therapy, plasmapheresis, and IVIG but deteriorated rapidly after steroid discontinuation, resulting in brain biopsy. On histopathologic confirmation consistent with anti-GABA-A receptor antibody-associated CNS inflammation, completing the first rituximab cycle, continuing oral corticosteroids and supplementing immunosuppression with cyclosporine A led to quick recovery. DISCUSSION: Our case describes a severe autoantibody-induced encephalitis in a young patient with MS, with alemtuzumab as a potential trigger for anti-GABA-A receptor encephalitis.

Indexed as

EncephalitisEpilepsia Partialis ContinuaMultiple SclerosisStatus EpilepticusAlemtuzumabFemaleHumansReceptors, GABA-AAlemtuzumabReceptors, GABA-A

Identifiers

PMID37202183
PMCPMC10195099
OpenAlexW4377047095

What OpenQuestion holds

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LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.