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The value of immunotherapy in children with initial short-term frequent seizures

This study aimed to discuss clinical characteristics, therapy, and antibody prevalence in epilepsy (APE) score for short-term, frequent epileptic seizures in children who are autoimmune-antibody negative and respond well to immunotherapy. The clinical characteristics, imaging manifestations, electro...

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Autores principales: Zhao, Yongheng, Li, Jun, Gao, Liang, Yang, Xiaofan, Zhao, Haiqing, Li, Yumei, Su, Li, Zhao, Xiaoyu, Ding, Hao, Li, Baomin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9490574/
https://www.ncbi.nlm.nih.gov/pubmed/36158962
http://dx.doi.org/10.3389/fneur.2022.948727
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author Zhao, Yongheng
Li, Jun
Gao, Liang
Yang, Xiaofan
Zhao, Haiqing
Li, Yumei
Su, Li
Zhao, Xiaoyu
Ding, Hao
Li, Baomin
author_facet Zhao, Yongheng
Li, Jun
Gao, Liang
Yang, Xiaofan
Zhao, Haiqing
Li, Yumei
Su, Li
Zhao, Xiaoyu
Ding, Hao
Li, Baomin
author_sort Zhao, Yongheng
collection PubMed
description This study aimed to discuss clinical characteristics, therapy, and antibody prevalence in epilepsy (APE) score for short-term, frequent epileptic seizures in children who are autoimmune-antibody negative and respond well to immunotherapy. The clinical characteristics, imaging manifestations, electrophysiology, and effective treatment plan of 9 children who met the above criteria were retrospectively analyzed in the Pediatric Neurology Department of Qilu Hospital at Shandong University from June 2019 to December 2021. All 9 patients (6 boys, 3 girls; aged 13 months−11 years and 5 months, median 3.5 years) had acute-onset seizures within 3 months. All had previous normal growth/development with no family history of disease. Seizure types were focal motor seizures (6), generalized tonic-clonic seizures (2), and generalized secondary-to-focal (1); occurred >10 times/day; and lasted <1 min/episode. Formal treatment with ≥2 types of antiseizure medicine (ASM) achieved an unsatisfactory effect. Cranial magnetic resonance imaging showed an abnormal result in 1 case. The APE score was ≥4 in 3 cases and <4 in 6 cases. All patients experienced symptomatic relief with immunotherapy; subsequently, 8 patients were free of recurrence and 1 had significantly reduced seizure frequency. Autoimmune antibody screening is recommended for children who were previously well and have acute-onset epilepsy; high frequency, short-duration seizures; no good response to 2 types of ASM; and other etiologic factors excluded, even with APE score <4. Even with negative autoimmune antibody results, the possibility of autoimmune epilepsy should be considered for urgent initiation of immunotherapy, which can achieve good results.
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spelling pubmed-94905742022-09-22 The value of immunotherapy in children with initial short-term frequent seizures Zhao, Yongheng Li, Jun Gao, Liang Yang, Xiaofan Zhao, Haiqing Li, Yumei Su, Li Zhao, Xiaoyu Ding, Hao Li, Baomin Front Neurol Neurology This study aimed to discuss clinical characteristics, therapy, and antibody prevalence in epilepsy (APE) score for short-term, frequent epileptic seizures in children who are autoimmune-antibody negative and respond well to immunotherapy. The clinical characteristics, imaging manifestations, electrophysiology, and effective treatment plan of 9 children who met the above criteria were retrospectively analyzed in the Pediatric Neurology Department of Qilu Hospital at Shandong University from June 2019 to December 2021. All 9 patients (6 boys, 3 girls; aged 13 months−11 years and 5 months, median 3.5 years) had acute-onset seizures within 3 months. All had previous normal growth/development with no family history of disease. Seizure types were focal motor seizures (6), generalized tonic-clonic seizures (2), and generalized secondary-to-focal (1); occurred >10 times/day; and lasted <1 min/episode. Formal treatment with ≥2 types of antiseizure medicine (ASM) achieved an unsatisfactory effect. Cranial magnetic resonance imaging showed an abnormal result in 1 case. The APE score was ≥4 in 3 cases and <4 in 6 cases. All patients experienced symptomatic relief with immunotherapy; subsequently, 8 patients were free of recurrence and 1 had significantly reduced seizure frequency. Autoimmune antibody screening is recommended for children who were previously well and have acute-onset epilepsy; high frequency, short-duration seizures; no good response to 2 types of ASM; and other etiologic factors excluded, even with APE score <4. Even with negative autoimmune antibody results, the possibility of autoimmune epilepsy should be considered for urgent initiation of immunotherapy, which can achieve good results. Frontiers Media S.A. 2022-09-01 /pmc/articles/PMC9490574/ /pubmed/36158962 http://dx.doi.org/10.3389/fneur.2022.948727 Text en Copyright © 2022 Zhao, Li, Gao, Yang, Zhao, Li, Su, Zhao, Ding and Li. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Zhao, Yongheng
Li, Jun
Gao, Liang
Yang, Xiaofan
Zhao, Haiqing
Li, Yumei
Su, Li
Zhao, Xiaoyu
Ding, Hao
Li, Baomin
The value of immunotherapy in children with initial short-term frequent seizures
title The value of immunotherapy in children with initial short-term frequent seizures
title_full The value of immunotherapy in children with initial short-term frequent seizures
title_fullStr The value of immunotherapy in children with initial short-term frequent seizures
title_full_unstemmed The value of immunotherapy in children with initial short-term frequent seizures
title_short The value of immunotherapy in children with initial short-term frequent seizures
title_sort value of immunotherapy in children with initial short-term frequent seizures
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9490574/
https://www.ncbi.nlm.nih.gov/pubmed/36158962
http://dx.doi.org/10.3389/fneur.2022.948727
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