Gifreu Ariadna, Falip Mercè, Sala-Padró Jacint, Mongay Neus, Morandeira Francisco, Camins Ángels, Naval-Baudin Pablo, Veciana Misericordia, Fernández Montserrat, Pedro Jordi, Garcia Belia, Arroyo Pablo, Simó Marta
Epilepsy Unit, Neurology Service, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, 08907 Barcelona, Spain.
Neurology Ward Unit, Neurology Service, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, 08907 Barcelona, Spain.
Brain Sci. 2021 Sep 8;11(9):1182. doi: 10.3390/brainsci11091182.
Acute symptomatic seizures (ASS) are a common manifestation of autoimmune encephalitis (AE), but the risk of developing epilepsy as a sequela of AE remains unknown, and factors predisposing the development of epilepsy have not been fully identified.
To assess the risk of developing epilepsy in AE and study related risk factors.
This was a retrospective single centre study including patients diagnosed with AE according to criteria described by Graus et al., with a minimum follow-up of 12 months after AE resolution. The sample was divided according to whether patients developed epilepsy or not.
A total of 19 patients were included; 3 (15.8%) had AE with intracellular antibodies, 9 (47.4%) with extracellular antibodies, and 7 (36.8%) were seronegative. During follow-up, 3 patients (15.8%) died, 4 (21.1%) presented relapses of AE, and 11 (57.89%) developed epilepsy. There was a significant association between the development of epilepsy and the presence of hippocampal atrophy in control brain magnetic resonance imaging (MRI) ( = 0.037), interictal epileptiform discharges (IED) on control electroencephalogram (EEG) ( = 0.045), and immunotherapy delay ( = 0.016).
Hippocampal atrophy in neuroimaging, IED on EEG during follow-up, and immunotherapy delay could be predictors of the development of epilepsy in patients with AE.
急性症状性癫痫发作（ASS）是自身免疫性脑炎（AE）的常见表现，但AE后遗症发展为癫痫的风险尚不清楚，且诱发癫痫发展的因素尚未完全明确。
评估AE患者发生癫痫的风险并研究相关危险因素。
这是一项回顾性单中心研究，纳入了根据Graus等人描述的标准诊断为AE的患者，AE缓解后至少随访12个月。根据患者是否发生癫痫对样本进行分组。
共纳入19例患者；3例（15.8%）患有伴有细胞内抗体的AE，9例（47.4%）伴有细胞外抗体，7例（36.8%）血清学阴性。随访期间，3例患者（15.8%）死亡，4例（21.1%）出现AE复发，11例（57.89%）发展为癫痫。癫痫的发生与对照脑磁共振成像（MRI）中海马萎缩的存在（P = 0.037）、对照脑电图（EEG）上的发作间期癫痫样放电（IED）（P = 0.045）以及免疫治疗延迟（P = 0.016）之间存在显著关联。
神经影像学中的海马萎缩、随访期间EEG上的IED以及免疫治疗延迟可能是AE患者癫痫发展的预测因素。
