Extreme delta brush evolving into status epilepticus in a patient with anti-NMDA encephalitis

Aline Herlopian; Eric S Rosenthal; Catherine J Chu; Andrew J Cole; Aaron F Struck

doi:10.1016/j.ebcr.2016.09.002

Extreme delta brush evolving into status epilepticus in a patient with anti-NMDA encephalitis

Epilepsy Behav Case Rep. 2016 Sep 25:7:69-71. doi: 10.1016/j.ebcr.2016.09.002. eCollection 2017.

Authors

Aline Herlopian¹, Eric S Rosenthal², Catherine J Chu³, Andrew J Cole⁴, Aaron F Struck⁵

Affiliations

¹ Department of Neurology, Division of Clinical Neurophysiology, Massachusetts General Hospital, WACC, Fruit St., Boston, MA 02114, United States.
² Massachusetts General Hospital, Department of Neurology, Division of Clinical Neurophysiology, Division of Neurocritical Care and Emergency Neurology, WACC 739-L, 55 Fruit St., Boston, MA 02114, United States.
³ Department of Neurology, Divisions of Child Neurology and Neurophysiology, Massachusetts General Hospital for Children, Suite 340, 175 Cambridge St., Boston, MA 02114, United States.
⁴ Massachusetts General Hospital, WACC 739-L, Fruit St., Boston, MA 02114, United States.
⁵ Department of Neurology, University of Wisconsin, Madison, 1685 Highland Avenue Madison, WI 53705-2281 United State.

Abstract

Extreme delta brush (EDB) is an EEG pattern unique to anti-NMDA encephalitis. It is correlated with seizures and status epilepticus in patients who have a prolonged course of illness. The etiology of the underlying association between EDB and seizures is not understood. We present a patient with anti-NMDA encephalitis who developed status epilepticus evolving from the high frequency activity of the extreme delta brush. This case demonstrates that EDB is not only a marker for a greater propensity for seizures but also directly implicated in seizure generation.

Keywords: Anti-NMDA encephalitis; Autoimmune epilepsy; Continuous EEG monitoring; Extreme delta brush; Ovarian teratoma; Status epilepticus.

Publication types

Case Reports

Grants and funding

K23 NS092923/NS/NINDS NIH HHS/United States