A case of post‐leptospirosis autoimmune epilepsy presenting with sleep‐related hypermotor seizures

Abstract

This video‐illustrated case report concerns a 49‐year‐old woman who presented with sleep‐related hypermotor seizures. The antecedent history of leptospirosis, high frequency of new‐onset seizures, presence of an unclassified anti‐neuronal antibody, and dramatic response to steroids strongly supported post‐infectious immune‐mediated pathogenesis in our patient. To the best of our knowledge, post‐leptospirosis autoimmune epilepsy presenting as sleep‐related hypermotor seizures has not hitherto been reported. [Published with video sequence on http://www.epilepticdisorders.com].

Severe Myasthenic Manifestation of Leptospirosis Associated with New Sequence Type ofLeptospira interrogans

“…In contrast, the patient we describe experienced more severe weakness at a much earlier point, and his serum sample tested positive for LRP4 autoantibodies, suggesting an association between MG and the acute leptospirosis. Reports of leptospirosis-associated, immune-mediated manifestations ranging from mononeuritis and Guillain-Barré–like syndromes to postinfectious autoimmune epilepsy ( 3 , 15 ) raise the question of whether Leptospira infections might precipitate or aggravate autoimmunity.…”