Generalized cortical encephalitis in autoimmune GFAP astrocytopathy.

We report a rare case of autoimmune glial fibrillary acidic protein astrocytopathy (GFAP-A) presenting with generalized cortical encephalitis. A 51-year-old woman developed subacute cognitive decline and seizure. Brain MRI revealed diffuse cortical T2-FLAIR hyperintensities, sulcal effacement, cerebral edema, and diffuse leptomeningeal enhancement. Anti-GFAP antibody was detected in both serum and cerebrospinal fluid. The patient responded well to immunotherapy, with significant clinical and radiological improvement. This case further expands the phenotypic spectrum of GFAP-A and suggests potential heterogeneity in its underlying pathogenesis.