A 35-year-old woman who experienced recurrent convulsions and neurological symptoms for nearly three months was eventually diagnosed with autoimmune encephalitis at KIMS Hospitals, Thane. She had consulted multiple hospitals, received treatment for seizures and was even prescribed antidepressants during her evaluation. However, her condition continued to worsen.
The turning point came when she developed severe convulsions during a scheduled 3-Tesla MRI at KIMS Hospitals. Doctors identified the underlying condition as autoimmune encephalitis, a rare disorder in which the immune system mistakenly attacks healthy brain tissue.
Normal EEG Raises Concern
Dr. Dipesh Pimple, Consultant Neurologist, KIMS Hospitals, Thane, evaluated the patient after the episode. Earlier investigations, including video EEG, were normal, while a PET scan showed hypometabolism. Dr. Siddharth Kharkar, Consultant Neurologist, had also suspected an autoimmune neurological disorder and advised continuing immunotherapy.
Despite anti-epileptic medications, the patient’s abnormal movements continued and did not resemble conventional seizures. She eventually required emergency intubation, ventilatory support and multiple medications. Both routine and prolonged EEG monitoring remained normal.
Based on the atypical seizure pattern, behavioural symptoms and normal EEG findings, Dr. Pimple suspected autoimmune encephalitis on the first day of admission.
Early Treatment Leads to Rapid Recovery
Doctors promptly initiated high-dose intravenous methylprednisolone after counselling the family. They also conducted a whole-body PET-MRI to rule out an underlying malignancy, as some forms of autoimmune encephalitis can be associated with hidden cancers. A high-resolution 3-Tesla MRI showed volume loss in the left temporal lobe, further supporting the diagnosis.
Although the abnormal movements initially reduced, some episodes persisted. Therefore, the team subsequently started intravenous immunoglobulin (IVIG) therapy.
As per the press release, the patient showed a remarkable response by the second day of IVIG treatment. Her abnormal movements reduced significantly, and she was gradually weaned off ventilatory support. With neurological rehabilitation, she regained her strength, began walking independently, resumed eating without assistance and returned to daily activities.
Importance of Early Diagnosis
Speaking about the case, Dr. Dipesh Pimple said autoimmune encephalitis can closely resemble epilepsy or psychiatric illness, making early diagnosis challenging. He emphasised that careful clinical assessment and early immunotherapy played a key role in controlling the disease and improving the patient’s recovery.
The patient’s treatment involved neurology, critical care, radiology, psychiatry, rehabilitation, nursing and allied healthcare teams. The case highlights the importance of considering autoimmune encephalitis when seizure-like episodes are unusual or do not respond as expected to conventional treatment. Early recognition and appropriate immunotherapy can significantly improve outcomes.