机构:[1]Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, 6 Tiantanxili, Dongcheng District, Beijing 100050, China重点科室诊疗科室神经病学中心神经病学中心首都医科大学附属天坛医院[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
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.
基金:
National Natural Science Foundation of ChinaNational Natural Science Foundation of China [81301119, 81471327]; Beijing Municipal Administration of Hospitals' Youth Programme [QML20160504]; China Association Against Epilepsy-UCB Research Fund [CAAE-UCB2016008]; National Key Technology Research and Development Program of the Ministry of Science and Technology of ChinaNational Key Technology R&D Program [2013BAI09B03]
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.
推荐引用方式(GB/T 7714):
Lv Rui-Juan,Ren Hai-Tao,Guan Hong-Zhi,et al.Seizure semiology: an important clinical clue to the diagnosis of autoimmune epilepsy[J].ANNALS OF CLINICAL AND TRANSLATIONAL NEUROLOGY.2018,5(2):208-215.doi:10.1002/acn3.520.
APA:
Lv, Rui-Juan,Ren, Hai-Tao,Guan, Hong-Zhi,Cui, Tao&Shao, Xiao-Qiu.(2018).Seizure semiology: an important clinical clue to the diagnosis of autoimmune epilepsy.ANNALS OF CLINICAL AND TRANSLATIONAL NEUROLOGY,5,(2)
MLA:
Lv, Rui-Juan,et al."Seizure semiology: an important clinical clue to the diagnosis of autoimmune epilepsy".ANNALS OF CLINICAL AND TRANSLATIONAL NEUROLOGY 5..2(2018):208-215