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...

Descripción completa

Detalles Bibliográficos
Autores principales: Lin, Nan, Bai, Lin, Liu, Qing, Chen, Jianhua, Ren, Haitao, Guan, Hongzhi, Lu, Qiang
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