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Seizures and risk of epilepsy in anti‐NMDAR, anti‐LGI1, and anti‐GABA(B)R encephalitis
BACKGROUND: Accumulating data have suggested seizures occur frequently in patients with neuronal surface antibody‐mediated autoimmune encephalitis. We aimed to evaluate seizure outcomes and potential factors associated with the development of epilepsy in patients with anti‐N‐methyl‐D‐aspartate recep...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7448167/ https://www.ncbi.nlm.nih.gov/pubmed/32710704 http://dx.doi.org/10.1002/acn3.51137 |
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author | Shen, Chun‐Hong Fang, Gao‐Li Yang, Fan Cai, Meng‐Ting Zheng, Yang Fang, Wei Guo, Yi Zhang, Yin‐Xi Ding, Mei‐Ping |
author_facet | Shen, Chun‐Hong Fang, Gao‐Li Yang, Fan Cai, Meng‐Ting Zheng, Yang Fang, Wei Guo, Yi Zhang, Yin‐Xi Ding, Mei‐Ping |
author_sort | Shen, Chun‐Hong |
collection | PubMed |
description | BACKGROUND: Accumulating data have suggested seizures occur frequently in patients with neuronal surface antibody‐mediated autoimmune encephalitis. We aimed to evaluate seizure outcomes and potential factors associated with the development of epilepsy in patients with anti‐N‐methyl‐D‐aspartate receptor (NMDAR), anti‐leucine‐rich glioma‐inactivated 1 (LGI1), and anti‐gamma‐aminobutyric‐acid B receptor (GABA(B)R) encephalitis. METHODS: Patients with anti‐NMDAR, anti‐LGI1, and anti‐GABA(B)R encephalitis were prospectively recruited from 2014 to June 2019, with a median follow‐up period of 30.5 months (range 8–67 months). Seizure outcomes were assessed and risk factors of epilepsy were analyzed. RESULTS: A total of 119 patients with anti‐NMDAR, anti‐LGI1, and anti‐GABA(B)R encephalitis were included, and 83 (69.7%) of them developed new‐onset seizures. By the end of follow‐up, 17 (21.3%) of 80 patients had seizure relapses after intermittent seizure remission or exhibited uncontrolled seizure episodes, contributing to epilepsy. Immunotherapy delay and interictal epileptic discharges (IEDs) were identified to be associated with the development of epilepsy in patients with anti‐NMDAR, anti‐LGI1, and anti‐GABA(B)R encephalitis, particularly anti‐NMDAR encephalitis. Furthermore, multivariate logistic regression analysis demonstrated that immunotherapy delay was an independent predictor for epilepsy. CONCLUSION: Our study suggested that immunotherapy delay and IEDs were associated with the development of epilepsy in patients with anti‐NMDAR, anti‐LGI1, and anti‐GABA(B)R encephalitis. Early diagnosis and treatment were required, and particular consideration should be given to patients with these risk factors. |
format | Online Article Text |
id | pubmed-7448167 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-74481672020-08-31 Seizures and risk of epilepsy in anti‐NMDAR, anti‐LGI1, and anti‐GABA(B)R encephalitis Shen, Chun‐Hong Fang, Gao‐Li Yang, Fan Cai, Meng‐Ting Zheng, Yang Fang, Wei Guo, Yi Zhang, Yin‐Xi Ding, Mei‐Ping Ann Clin Transl Neurol Research Articles BACKGROUND: Accumulating data have suggested seizures occur frequently in patients with neuronal surface antibody‐mediated autoimmune encephalitis. We aimed to evaluate seizure outcomes and potential factors associated with the development of epilepsy in patients with anti‐N‐methyl‐D‐aspartate receptor (NMDAR), anti‐leucine‐rich glioma‐inactivated 1 (LGI1), and anti‐gamma‐aminobutyric‐acid B receptor (GABA(B)R) encephalitis. METHODS: Patients with anti‐NMDAR, anti‐LGI1, and anti‐GABA(B)R encephalitis were prospectively recruited from 2014 to June 2019, with a median follow‐up period of 30.5 months (range 8–67 months). Seizure outcomes were assessed and risk factors of epilepsy were analyzed. RESULTS: A total of 119 patients with anti‐NMDAR, anti‐LGI1, and anti‐GABA(B)R encephalitis were included, and 83 (69.7%) of them developed new‐onset seizures. By the end of follow‐up, 17 (21.3%) of 80 patients had seizure relapses after intermittent seizure remission or exhibited uncontrolled seizure episodes, contributing to epilepsy. Immunotherapy delay and interictal epileptic discharges (IEDs) were identified to be associated with the development of epilepsy in patients with anti‐NMDAR, anti‐LGI1, and anti‐GABA(B)R encephalitis, particularly anti‐NMDAR encephalitis. Furthermore, multivariate logistic regression analysis demonstrated that immunotherapy delay was an independent predictor for epilepsy. CONCLUSION: Our study suggested that immunotherapy delay and IEDs were associated with the development of epilepsy in patients with anti‐NMDAR, anti‐LGI1, and anti‐GABA(B)R encephalitis. Early diagnosis and treatment were required, and particular consideration should be given to patients with these risk factors. John Wiley and Sons Inc. 2020-07-25 /pmc/articles/PMC7448167/ /pubmed/32710704 http://dx.doi.org/10.1002/acn3.51137 Text en © 2020 The Authors. Annals of Clinical and Translational Neurology published by Wiley Periodicals LLC on behalf of American Neurological Association This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Research Articles Shen, Chun‐Hong Fang, Gao‐Li Yang, Fan Cai, Meng‐Ting Zheng, Yang Fang, Wei Guo, Yi Zhang, Yin‐Xi Ding, Mei‐Ping Seizures and risk of epilepsy in anti‐NMDAR, anti‐LGI1, and anti‐GABA(B)R encephalitis |
title | Seizures and risk of epilepsy in anti‐NMDAR, anti‐LGI1, and anti‐GABA(B)R encephalitis |
title_full | Seizures and risk of epilepsy in anti‐NMDAR, anti‐LGI1, and anti‐GABA(B)R encephalitis |
title_fullStr | Seizures and risk of epilepsy in anti‐NMDAR, anti‐LGI1, and anti‐GABA(B)R encephalitis |
title_full_unstemmed | Seizures and risk of epilepsy in anti‐NMDAR, anti‐LGI1, and anti‐GABA(B)R encephalitis |
title_short | Seizures and risk of epilepsy in anti‐NMDAR, anti‐LGI1, and anti‐GABA(B)R encephalitis |
title_sort | seizures and risk of epilepsy in anti‐nmdar, anti‐lgi1, and anti‐gaba(b)r encephalitis |
topic | Research Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7448167/ https://www.ncbi.nlm.nih.gov/pubmed/32710704 http://dx.doi.org/10.1002/acn3.51137 |
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