Cargando…
Seizure semiology and predictors of outcomes in Chinese patients with glutamic acid decarboxylase antibody-associated neurological syndrome
BACKGROUND: In the current study, seizure semiology and potential predictive factors of seizure outcomes in glutamic acid decarboxylase antibody (GAD Ab)-associated neurological syndrome were investigated. METHODS: In this study, 32 Chinese patients with GAD Ab-associated neurological syndrome who p...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10088211/ https://www.ncbi.nlm.nih.gov/pubmed/37041500 http://dx.doi.org/10.1186/s12883-023-03182-x |
_version_ | 1785022524169388032 |
---|---|
author | Lin, Nan Bai, Lin Liu, Qing Chen, Jianhua Ren, Haitao Guan, Hongzhi Lu, Qiang |
author_facet | Lin, Nan Bai, Lin Liu, Qing Chen, Jianhua Ren, Haitao Guan, Hongzhi Lu, Qiang |
author_sort | Lin, Nan |
collection | PubMed |
description | BACKGROUND: In the current study, seizure semiology and potential predictive factors of seizure outcomes in glutamic acid decarboxylase antibody (GAD Ab)-associated neurological syndrome were investigated. METHODS: In this study, 32 Chinese patients with GAD Ab-associated neurological syndrome who presented with seizures at Peking Union Medical College Hospital from January 2017 to October 2022 were reviewed; 30 had a follow-up duration of more than 1 year. RESULTS: Among the 32 patients, 10 presented with epilepsy alone. Concomitant neurological syndromes were observed in 22 patients, including limbic encephalitis (n = 20), stiff-person syndrome (SPS, n = 1), and cerebellar ataxia (n = 1). Bilateral tonic–clonic seizures were observed in 21 patients (65.6%). Focal seizures occurred in 27 patients (84.4%); 17 had focal motor seizures and 18 focal non-motor seizures. Among 30 patients with long-term follow-up, 11 (36.7%) were seizure-free. Acute/subacute onset (p = 0.049) and comorbidity of limbic encephalitis with epilepsy (p = 0.023) led to better seizure outcomes. Patients with persistent epilepsy were more likely to have focal seizure (p = 0.003) and higher frequency of seizure (p = 0.001). Furthermore, these patients tended to have longer intervals from onset to immunomodulatory treatments. Early immunotherapy (within 6 months from onset) was administered in 81.8% of seizure-free patients but only in 42.1% of patients with persistent seizures. However, steroid and immunosuppressant duration did not differ in the two groups. Repeated serum GAD Ab tests during the follow-up showed no association with seizure outcomes. CONCLUSIONS: The seizure manifestations are diverse and variable. Approximately one third of patients achieved seizure remission during long-term follow-up. The type and frequency of seizures may influence the seizure outcomes. Early immunotherapy, especially within 6 months, may lead to better seizure outcomes. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12883-023-03182-x. |
format | Online Article Text |
id | pubmed-10088211 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-100882112023-04-12 Seizure semiology and predictors of outcomes in Chinese patients with glutamic acid decarboxylase antibody-associated neurological syndrome Lin, Nan Bai, Lin Liu, Qing Chen, Jianhua Ren, Haitao Guan, Hongzhi Lu, Qiang BMC Neurol Research BACKGROUND: In the current study, seizure semiology and potential predictive factors of seizure outcomes in glutamic acid decarboxylase antibody (GAD Ab)-associated neurological syndrome were investigated. METHODS: In this study, 32 Chinese patients with GAD Ab-associated neurological syndrome who presented with seizures at Peking Union Medical College Hospital from January 2017 to October 2022 were reviewed; 30 had a follow-up duration of more than 1 year. RESULTS: Among the 32 patients, 10 presented with epilepsy alone. Concomitant neurological syndromes were observed in 22 patients, including limbic encephalitis (n = 20), stiff-person syndrome (SPS, n = 1), and cerebellar ataxia (n = 1). Bilateral tonic–clonic seizures were observed in 21 patients (65.6%). Focal seizures occurred in 27 patients (84.4%); 17 had focal motor seizures and 18 focal non-motor seizures. Among 30 patients with long-term follow-up, 11 (36.7%) were seizure-free. Acute/subacute onset (p = 0.049) and comorbidity of limbic encephalitis with epilepsy (p = 0.023) led to better seizure outcomes. Patients with persistent epilepsy were more likely to have focal seizure (p = 0.003) and higher frequency of seizure (p = 0.001). Furthermore, these patients tended to have longer intervals from onset to immunomodulatory treatments. Early immunotherapy (within 6 months from onset) was administered in 81.8% of seizure-free patients but only in 42.1% of patients with persistent seizures. However, steroid and immunosuppressant duration did not differ in the two groups. Repeated serum GAD Ab tests during the follow-up showed no association with seizure outcomes. CONCLUSIONS: The seizure manifestations are diverse and variable. Approximately one third of patients achieved seizure remission during long-term follow-up. The type and frequency of seizures may influence the seizure outcomes. Early immunotherapy, especially within 6 months, may lead to better seizure outcomes. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12883-023-03182-x. BioMed Central 2023-04-11 /pmc/articles/PMC10088211/ /pubmed/37041500 http://dx.doi.org/10.1186/s12883-023-03182-x Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Lin, Nan Bai, Lin Liu, Qing Chen, Jianhua Ren, Haitao Guan, Hongzhi Lu, Qiang Seizure semiology and predictors of outcomes in Chinese patients with glutamic acid decarboxylase antibody-associated neurological syndrome |
title | Seizure semiology and predictors of outcomes in Chinese patients with glutamic acid decarboxylase antibody-associated neurological syndrome |
title_full | Seizure semiology and predictors of outcomes in Chinese patients with glutamic acid decarboxylase antibody-associated neurological syndrome |
title_fullStr | Seizure semiology and predictors of outcomes in Chinese patients with glutamic acid decarboxylase antibody-associated neurological syndrome |
title_full_unstemmed | Seizure semiology and predictors of outcomes in Chinese patients with glutamic acid decarboxylase antibody-associated neurological syndrome |
title_short | Seizure semiology and predictors of outcomes in Chinese patients with glutamic acid decarboxylase antibody-associated neurological syndrome |
title_sort | seizure semiology and predictors of outcomes in chinese patients with glutamic acid decarboxylase antibody-associated neurological syndrome |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10088211/ https://www.ncbi.nlm.nih.gov/pubmed/37041500 http://dx.doi.org/10.1186/s12883-023-03182-x |
work_keys_str_mv | AT linnan seizuresemiologyandpredictorsofoutcomesinchinesepatientswithglutamicaciddecarboxylaseantibodyassociatedneurologicalsyndrome AT bailin seizuresemiologyandpredictorsofoutcomesinchinesepatientswithglutamicaciddecarboxylaseantibodyassociatedneurologicalsyndrome AT liuqing seizuresemiologyandpredictorsofoutcomesinchinesepatientswithglutamicaciddecarboxylaseantibodyassociatedneurologicalsyndrome AT chenjianhua seizuresemiologyandpredictorsofoutcomesinchinesepatientswithglutamicaciddecarboxylaseantibodyassociatedneurologicalsyndrome AT renhaitao seizuresemiologyandpredictorsofoutcomesinchinesepatientswithglutamicaciddecarboxylaseantibodyassociatedneurologicalsyndrome AT guanhongzhi seizuresemiologyandpredictorsofoutcomesinchinesepatientswithglutamicaciddecarboxylaseantibodyassociatedneurologicalsyndrome AT luqiang seizuresemiologyandpredictorsofoutcomesinchinesepatientswithglutamicaciddecarboxylaseantibodyassociatedneurologicalsyndrome |