000 02222cam a2200289 4500500
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041 _afre
042 _adc
100 1 0 _aTakebayashi, Yoshiko
_eauthor
700 1 0 _a Neshige, Shuichiro
_eauthor
700 1 0 _a Hayashi, Tetsutaro
_eauthor
700 1 0 _a Aoki, Shiro
_eauthor
700 1 0 _a Ueno, Hiroki
_eauthor
700 1 0 _a Iida, Koji
_eauthor
700 1 0 _a Maruyama, Hirofumi
_eauthor
245 0 0 _aA case of repetitive seizures following immune checkpoint inhibitor therapy as a feature of autoimmune encephalitis
260 _c2021.
500 _a69
520 _aPembrolizumab, an immune-checkpoint inhibitor (ICI), is a humanized monoclonal antibody that binds to programmed cell death-1 receptor (PD-1) and thereby inhibits binding to its ligand, which inhibits the suppression of activated T cells by cancer cells, resulting in enhancing antitumour immunity. Although several cases of encephalitis have been reported as immune-related adverse effects of ICIs, epilepsy has not been reported following ICI treatment. We describe the case of an elderly woman with bladder carcinoma who experienced two episodes of generalized seizures after treatment with pembrolizumab. The episodes were atypical of encephalitis, because the seizures were completely responsive to AEDs and the CSF parameters normalized completely without immunotherapy. Since interictal EEG revealed persistent epileptic discharges after the seizures, pembrolizumab was considered to have induced a chronic state of epileptogenicity as the possible pathology, with a clinical picture similar to that of autoimmune epilepsy. The possibility that ICIs may cause an immune-related adverse effect, such as a chronic epileptic condition, should be considered, since ICIs are used widely.
690 _aimmune-related adverse effect
690 _ablood brain barrier
690 _atemporal intermittent rhythmic delta activity
690 _aimmune-checkpoint inhibitors
690 _aautoimmune epilepsy
786 0 _nEpileptic Disorders | Vol 23 | 5 | 2021-05-01 | p. 733-738 | 1294-9361
856 4 1 _uhttps://shs.cairn.info/revue-epileptic-disorders-2021-5-page-733?lang=en&redirect-ssocas=7080
999 _c611824
_d611824