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Voltage-gated potassium channel complex encephalitis is a common form of autoimmune encephalitis presenting with intractable seizures that may respond to immunotherapy. These authors reviewed the imaging findings in 42 such patients and the most common abnormalities noted were enlargement, T2 hyperintensity, contrast enhancement, and restricted diffusion in the mesial temporal lobes with subsequent development of hippocampal atrophy. Because the disease can be confirmed easily by the presence of voltage-gated potassium channel complex antibodies, these imaging findings should prompt serologic testing.