Benjamin R Kummer, Bethany L Johnson Kerner and Charles C Esenwa
A 65-year-old man presented for evaluation of altered mental status, preceded by several months of sleep abnormalities, excessive salivation, and paroxysms of drenching sweats. Despite having no history of diabetes mellitus, he was severely hyperglycemic with a hemoglobin A1C of 11%. Serum tests revealed hyponatremia as well as positive Voltage-Gated Potassium Channel (VGKC) serum antibodies, and EEG showed frequent epileptic discharges originating from the left temporal lobe. He was ultimately diagnosed with VGKC antibody encephalitis and was treated with antiepileptic, anti-diabetic and corticosteroid agents with improvement in his mental status. One year following treatment, he was seizure-free, had returned to his baseline level of function, and had been weaned off both corticosteroids and anti-diabetic medications.
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