{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T06:52:07Z","timestamp":1777877527013,"version":"3.51.4"},"reference-count":15,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2020,8,25]],"date-time":"2020-08-25T00:00:00Z","timestamp":1598313600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Neurohospitalist"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:p>Hospital neurologists participate at the forefront of managing fulminant acute and subacute onset epilepsy, frequently attributed to autoimmune encephalitis (AE). As the recognition of antibody-mediated AE grows, there is a growing number of patients who are treated as antibody-negative AE. While antibody-negative autoimmune processes should be considered in the setting of acute and subacute onset of fulminant epilepsy, other causes must be considered before subjecting patients to long-term immunomodulatory treatments and other potential therapeutic toxicities. We present the case of a previously healthy young man who presented with new-onset refractory seizures treated with escalating doses of anti-epileptic drugs as well as immunosuppression for presumed autoimmune epilepsy. He developed valproic acid induced hepatotoxicity requiring liver transplantation and was later found to have a POLG mutation. We discuss the presentation of POLG mutations as well as the diagnosis of seronegative autoimmune encephalitis. We highlight the need for a broad differential when evaluating new onset refractory seizures in an otherwise healthy person.<\/jats:p>","DOI":"10.1177\/1941874420952263","type":"journal-article","created":{"date-parts":[[2020,8,25]],"date-time":"2020-08-25T06:58:53Z","timestamp":1598338733000},"page":"80-83","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Genetic or Autoimmune: POLG-Related Epilepsy Initially Treated as an Autoimmune Encephalitis, a Case Report"],"prefix":"10.1177","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3989-944X","authenticated-orcid":false,"given":"Suma","family":"Shah","sequence":"first","affiliation":[{"name":"Duke University Medical Center, Durham, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abigail","family":"Berezoski","sequence":"additional","affiliation":[{"name":"Duke University Medical Center, Durham, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shareena","family":"Rahman","sequence":"additional","affiliation":[{"name":"Duke University Medical Center, Durham, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Eckstein","sequence":"additional","affiliation":[{"name":"Duke University Medical Center, Durham, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Luedke","sequence":"additional","affiliation":[{"name":"Duke University Medical Center, Durham, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,8,25]]},"reference":[{"key":"bibr1-1941874420952263","doi-asserted-by":"publisher","DOI":"10.1055\/s-0036-1585453"},{"key":"bibr2-1941874420952263","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2017.00395"},{"key":"bibr3-1941874420952263","doi-asserted-by":"publisher","DOI":"10.1097\/WCO.0000000000000304"},{"key":"bibr4-1941874420952263","doi-asserted-by":"publisher","DOI":"10.1007\/s00401-015-1481-5"},{"issue":"1","key":"bibr5-1941874420952263","first-page":"227","volume":"22","author":"Gaspard N","year":"2016","journal-title":"Continuum (Minneapolis, Minn)"},{"key":"bibr6-1941874420952263","doi-asserted-by":"publisher","DOI":"10.1055\/s-0035-1552625"},{"key":"bibr7-1941874420952263","doi-asserted-by":"publisher","DOI":"10.1002\/ana.20079"},{"key":"bibr8-1941874420952263","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000098997.23471.65"},{"key":"bibr9-1941874420952263","doi-asserted-by":"publisher","DOI":"10.1038\/s41582-018-0101-0"},{"key":"bibr10-1941874420952263","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awn007"},{"key":"bibr11-1941874420952263","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2010.01.002"},{"key":"bibr12-1941874420952263","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(15)00401-9"},{"key":"bibr13-1941874420952263","doi-asserted-by":"publisher","DOI":"10.1111\/j.1528-1167.2005.00350.x"},{"key":"bibr14-1941874420952263","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2005.088070"},{"key":"bibr15-1941874420952263","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2015.11.007"}],"container-title":["The Neurohospitalist"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1941874420952263","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1941874420952263","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1941874420952263","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T22:53:50Z","timestamp":1777589630000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1941874420952263"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,25]]},"references-count":15,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,1]]}},"alternative-id":["10.1177\/1941874420952263"],"URL":"https:\/\/doi.org\/10.1177\/1941874420952263","relation":{},"ISSN":["1941-8744","1941-8752"],"issn-type":[{"value":"1941-8744","type":"print"},{"value":"1941-8752","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,8,25]]}}}