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Seizure semiology: an important clinical clue to the diagnosis of autoimmune epilepsy

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机构: [1]Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, 6 Tiantanxili, Dongcheng District, Beijing 100050, China [2]China National Clinical Research Center for Neurological Diseases, 6 Tiantanxili, Dongcheng District, Beijing 100050, China [3]Department of Neurology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
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Objective: The purpose of this study is to analyze the seizure semiologic characteristics of patients with autoimmune epilepsy (AE) and describe the investigation characteristics of AE using a larger sample size. Methods: 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. 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-GABA(B)-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. Significance: 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.

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出版当年[2017]版:
大类 | 2 区 医学
小类 | 2 区 临床神经病学 3 区 神经科学
最新[2023]版:
大类 | 2 区 医学
小类 | 2 区 临床神经病学 2 区 神经科学
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出版当年[2016]版:
Q1 CLINICAL NEUROLOGY Q2 NEUROSCIENCES
最新[2023]版:
Q1 CLINICAL NEUROLOGY Q1 NEUROSCIENCES

影响因子: 最新[2023版] 最新五年平均 出版当年[2016版] 出版当年五年平均 出版前一年[2015版] 出版后一年[2017版]

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第一作者机构: [1]Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, 6 Tiantanxili, Dongcheng District, Beijing 100050, China [2]China National Clinical Research Center for Neurological Diseases, 6 Tiantanxili, Dongcheng District, Beijing 100050, China
通讯作者:
通讯机构: [1]Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, 6 Tiantanxili, Dongcheng District, Beijing 100050, China [2]China National Clinical Research Center for Neurological Diseases, 6 Tiantanxili, Dongcheng District, Beijing 100050, China [*1]Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, 6 Tiantanxili, Dongcheng District, Beijing 100050, China.
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