3126 Not a laughing matter! Brisk reflexes despite absent snaps with isolated lateral cord MRI T2-hyperintensity secondary to nitrous oxide toxicity

perampanel) in addition to plasma exchange.In discussion with immunology, cyclophosphamide induction commenced.She was seizure-free on day 4 intensive care (ICU) admission.Anaesthesia and ASMs were gradually weaned.She was discharged following 41-day ICU admission and 3-month inpatient stay.She remains seizure-free 18 months since admission.Discussion Thymoma can present with paraneoplastic neurological syndromes.There is no clear evidence that anti-GAD/ anti-Hu antibodies are pathogenic in the associated syndrome.The case highlights the importance of aggressive multimodal immunotherapy in the setting of super-refractory status epilepticus of autoimmune aetiology.