PMC8551914_01
EEG showing bilateral frontoparietal polyspikes and spike-and-wave discharges, predominantly on the right hemisphere.
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Brain MRI showed very few non-specific white matter lesions and electroencephalography (EEG) showed bilateral frontoparietal polyspikes and spike-and-wave discharges, predominantly on the right hemisphere ( Figure 1 ).
Brain MRI Flair sequences showing new confluent subcortical white matter lesions compatible with inflammation (red arrows) (A, B).
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However, brain MRI showed new subcortical white matter lesions especially in the left parietal lobe ( Figure 2 ), which considering the clinical scenario and the age of the patient were highly suggestive of AE, fulfilling the criteria for probable seronegative AE.
Clinical course timeline during the first 15 months of follow-up, with three clinical relapses and subsequent improvement after immunotherapy administration. IVIG, intravenous immunoglobulins; mRS, modified Rankin score; RTX, rituximab.
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AE, with an excellent clinical response ( Figure 3 ). After 24 months of follow-up, she had a good recovery reaching an mRS of 3, being able to have a partially autonomous life, attend school and maintain social relationships, despite cognitive disturbances being slightly worse than before the disease.