Autoimmune encephalitis with elevated N-type calcium channel antibodies as a multiple sclerosis mimic

Background: Voltage gated calcium channels (VGCC) are well-known targets for antibody-associated disease. Of the 5 VGCC subtypes, the most well-known is the P/Q subtype associated with Lambert-Eaton Myasthenic Syndrome (LEMS). However, this case focuses on the much less understood N-type calcium channel antibody. The objective of this case is to review the literature regarding the clinical significance of the N-type calcium channel antibody and its relationship to MS. Methods: A 37-year old male presented with vertigo, paranoia, and tremor and had MRI changes suggestive of demyelinating disease. Evaluation revealed positive N-type calcium channel antibodies. Steroids dramatically improved symptoms and normalized antibodies. Years later recurrent symptoms were again associated with elevated antibodies. Results and Conclusion: This patient likely has autoimmune encephalitis associated with elevated N-type calcium channel antibodies. This case highlights the clinical significance of N-type calcium channel antibodies and the importance of correctly diagnosing patients with antibody mediated disease that may very well mimic more common neurologic diseases such as multiple sclerosis (MS).