In addition to antibody panels, what finding may support an autoimmune process in new-onset seizures?

• A. MRI findings may support autoimmune processes.
• B. EEG is always normal
• C. Blood glucose extremely high
• D. Vitamin D deficiency

Answer: (A)

When evaluating new-onset seizures for an autoimmune cause, imaging findings on MRI can provide supportive evidence beyond antibody testing. MRI can reveal inflammatory changes in regions commonly affected by autoimmune encephalitis, especially the limbic system. Mesial temporal lobe T2/FLAIR hyperintensities, sometimes with contrast enhancement or diffusion changes, can point toward an autoimmune process and help guide further testing and early immunotherapy in the right clinical context.

EEG is not reliably normal in autoimmune encephalitis—many patients show slowing, focal or generalized epileptiform activity, or other abnormal patterns—so the idea that EEG is always normal isn’t accurate. A drastically high blood glucose or a vitamin D deficiency can cause seizures or other symptoms, but they don’t specifically indicate an autoimmune mechanism.