Contactin-associated protein 2 (Caspr2) antibodies associated with refractory temporal seizures, rapid cognitive decline, and emotional lability
Bibliographic record
Abstract
Background: Caspr2 is a transmembrane protein facilitating intercellular communication. It is found primarily in the central nervous system, specifically cerebellum and hippocampus. Anti-Caspr2 antibodies, more commonly seen in men (M/F: 4), also bind voltage-gated potassium channels. The antibodies are associated with limbic encephalitis, seizures, Morvan’s syndrome, peripheral nerve hyperexcitability, and cerebellar ataxia. Malignancy exists in 20% of cases. Methods: Case report and review of literature. Results: A 71-year-old man presented with subacute onset refractory seizures failing several anti-convulsants, emotional lability, and rapid decline in memory and executive function. EEG showed an electrographic seizure over the left hemisphere. MRI brain demonstrated mild diffuse cerebral atrophy, chronic ischemic changes, and mild diffusion restriction in the medial frontal lobes. Cerebrospinal fluid was normal. Serum Antithyroid peroxidase and antithyroglobulin antibodies were negative. TSH was slightly elevated and eltroxin didn’t help. Anti-Caspr2 antibodies were highly positive. EMG ruled out neuromyotonia. Body CT and PET scans indicated no malignancy. Treatment with IVIG stopped the seizures and cognition dramatically improved. Conclusions: Recognizing anti-Caspr2 antibody-associated encephalitis in elderly males with new onset refractory epilepsy and rapid cognitive decline is important for timely initiation of immunomodulation to avoid permanent deficits. Rapid executive dysfunction was unique in this case.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".