{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T05:47:44Z","timestamp":1785822464868,"version":"3.56.0"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>Anti-gamma-aminobutyric acid type B receptor (anti-GABA-B receptor) encephalitis is a rare autoimmune limbic encephalitis that frequently presents with seizures and may be associated with malignancy, most commonly small-cell lung cancer. We report a 66-year-old man with anti-GABA-B receptor encephalitis who presented with a witnessed generalized tonic\u2013clonic seizure after a 2-day prodrome of nocturnal repetitive stereotyped behaviors retrospectively suspicious for subtle focal seizures with automatisms. Brain magnetic resonance imaging showed right-predominant hippocampal and multifocal cortical hyperintensities, and cerebrospinal fluid analysis showed mild pleocytosis and elevated protein with negative infectious testing. He deteriorated on hospital day 5 with refractory status epilepticus and hypoxemic respiratory failure requiring intubation and intensive care. Anti-GABA-B receptor antibodies were subsequently confirmed in both serum and cerebrospinal fluid. Initial malignancy evaluation included contrast-enhanced computed tomography of the chest, abdomen, and pelvis; serum tumor markers; and an onconeural antibody panel. No malignancy was detected. Treatment included intravenous methylprednisolone, 10 sessions of therapeutic plasma exchange, and multi-agent antiseizure therapy. He was extubated after approximately 2 weeks and discharged on hospital day 39 with a modified Rankin Scale score of 3. At 3 months, he was seizure-free, with a modified Rankin Scale score of 1, a Barthel Index of 95\/100, and a Mini-Mental State Examination score of 30\/30. This single uncontrolled case is hypothesis-generating and does not establish treatment efficacy, optimal plasma exchange duration, long-term prognosis, or definitive non-paraneoplastic status. It illustrates that new-onset refractory status epilepticus should prompt expedited autoimmune encephalitis evaluation and that structured oncologic surveillance remains necessary despite negative initial tumor screening.<\/jats:p>","DOI":"10.3389\/fimmu.2026.1896400","type":"journal-article","created":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T05:39:30Z","timestamp":1785821970000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Anti-GABA-B receptor encephalitis with refractory status epilepticus and favorable short-term recovery"],"prefix":"10.3389","volume":"17","author":[{"given":"Min-Jing","family":"Chou","sequence":"first","affiliation":[{"name":"Department of Neurology, Tri-Service General Hospital, National Defense Medical University","place":["Taipei, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pang-Yen","family":"Hsu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Tri-Service General Hospital, National Defense Medical University","place":["Taipei, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming-Chen","family":"Tsai","sequence":"additional","affiliation":[{"name":"Department of Neurology, Tri-Service General Hospital, National Defense Medical University","place":["Taipei, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih-Wei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Radiology, Tri-Service General Hospital, National Defense Medical University","place":["Taipei, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fu-Chi","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Tri-Service General Hospital, National Defense Medical 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