Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
Seizure semiology: an important clinical clue to the diagnosis of autoimmune epilepsy
First author：Lv Rui-Juan
Corresponding author：Shao Xiao-Qiu
essential_information
- Person in charge：Lv Rui-Juan
- Data Sources： OTHERS
- Number of papers：OTHERS20190628
- Published time：2018-02-01
2018-02-01
Published articles
Journal：Ann Clin Transl Neurol
Publication type: Research Article
IF(IF): 4.656
PMID: 29468181 Link To Pubmed Full text Download
Background And Purpose
Method
This observational retrospective case series study was conducted from a tertiary epilepsy center between May 2014 and March 2017. Cases of new-onset seizures were selected based on laboratory evidence of autoimmunity. At the same time, typical mesial temporal lobe epilepsy (MTLE) patients with hippocampal sclerosis (HS) were recruited as the control group from the subjects who underwent presurgical evaluation during the same period.
Conclusion
This study highlights important seizure semiologic characteristics of AE. Patients with autoimmune epilepsy had special seizure semiologic characteristics. For patients with autoimmune epilepsy presenting with new-onset seizures in isolation or with a seizure-predominant neurological disorder, the special seizure semiologic characteristics may remind us to test neuronal nuclear/cytoplasmic antibodies early and initiate immunomodulatory therapies as soon as possible. Furthermore, the absence of neural-specific autoantibodies does not rule out AE.
Main results
A total of 61 patients with AE were identified. Specific autoimmune antibodies were detected in 39 patients (63.93%), including anti-VGKC in 23 patients (37.70%), anti-NMDA-R in 9 patients (14.75%), anti-GABAB-R in 6 patients (9.84%), and anti-amphiphysin in 1 patient (1.64%). Regarding the seizure semiology, no significant differences were noted between AE patients with autoantibody and patients with suspected AE without antibody. Compared to typical MTLE patients with HS, both AE patients with autoantibody and patients with suspected AE without antibody had the same seizure semiologic characteristics, including more frequent SPS or CPS, shorter seizure duration, rare postictal confusion, and common sleeping SGTC seizures.