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Tonic Seizure as a Different Seizure Type Presented in Autoimmune Epilepsy Caused by Systemic Lupus Erythematosus

Lv, Yudan, PhD; Zheng, Xiangyu, PhD; Zhang, Xiao, MD; Zhao, Danyang, MD; Cui, Li, PhD

The Journal of Nervous and Mental Disease: March 2019 - Volume 207 - Issue 3 - p 188–191
doi: 10.1097/NMD.0000000000000946
Original Articles

The diagnosis of autoimmune epilepsy is often challenging, and may be misdiagnosed as epileptic disorders or viral encephalitis. Autoimmune epilepsy has a strong association with other autoimmune diseases, especially systemic lupus erythematosus (SLE). In addition, autoimmune epilepsy was reported to present with complex partial seizure (CPS), simple partial seizure (SPS), and secondarily generalized tonic-clonic seizure (sGTCS). In our case, we present a different seizure type of tonic seizure in autoimmune epilepsy caused by SLE, which has not been reported, and it will provide with a new understanding of autoimmune epilepsy. A 17-year-old Chinese girl was diagnosed as having SLE for 1 month but with no epilepsy history. After this admission, she presented with different seizure types. Then EEG, magnetic resonance imaging, and lumbar puncture were performed. We have found generalized tonic seizure and excluded CNS infection and lupus encephalopathy. After antiepileptic therapy, no improvement has been found in seizure control. According to the previous history, clinical manifestation, and relevant examinations, we have made a clinical diagnosis of autoimmune epilepsy (tonic seizure) and SLE has been confirmed again by the immunological test. After the hormonotherapy, anti-inflammatory, and anti-tuberculosis therapy, the tonic seizure decreased significantly, and patient's consciousness improved. Autoimmune epilepsy should call the attentions of the clinicians, especially when the patient presented with SLE. Tonic seizure has not been described in autoimmune epilepsy before, which was different from other seizures reported, such as SPS, CPS, and sGTCS, and may bring a new insight into the autoimmune epilepsy.

Department of Neurology, Department of Neurology and Neuroscience Center, The First Hospital of JiLin University, Changchun, People's Republic of China.

This case report was supported by a grant from the National Natural Science Foundation of China (grant number 81701270).

Send reprint requests to Yudan Lv, PhD, Department of Neurology, The First Hospital of JiLin University, 71 Xinmin St, Changchun, People's Republic of China. E-mail:

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