Possible induction of multiple seizure foci due to parietal tumour and anti-NMDAR antibody

“Formes frustes” of encephalopathy associated with anti-NMDAR antibody have been recently described in cases of chronic epilepsy. We report a young woman with a parietal lesion and anti-NMDAR antibody who acquired bilateral, secondary epileptogenesis in the temporal lobes within a period as short as six years. Removal of the primary epileptogenic lesion of oligoastrocytoma in the right parietal lobe resulted in seizure freedom, disappearance of secondary foci, and substantial decrease of the antibody titre. Chronic exposure to anti-NMDAR antibody, albeit at a low titre, may have resulted in a smoldering chronic course and relatively early acquisition of “reversible” secondary foci without development of a high degree of epileptogenicity and structural changes.