Department of Neurology, First Hospital, Jilin University, Changchun, China.
Department of Hepatology, Second People's Clinical College of Tianjin Medical University, Tianjin, China.
Front Immunol. 2022 Feb 23;13:813174. doi: 10.3389/fimmu.2022.813174. eCollection 2022.
To investigate the clinical characteristics of acute symptomatic seizures and the predictors of the development of epilepsy in patients with anti-NMDAR, anti-LGI1, and anti-GABABR encephalitis.
We retrospectively screened the medical records of 86 hospitalized patients with confirmed autoimmune encephalitis (AE). The clinical characteristics of acute symptomatic seizures were analyzed. The predictors of the development of epilepsy were investigated using logistic regression analysis.
A total of 86 patients with AE were finally included. Eighty-six percent of patients (n = 74) experienced acute symptomatic seizures, and 28.4% of patients developed epilepsy during follow-up. Abnormal EEG findings were more frequent in AE patients with acute symptomatic seizures. A greater number of anti-seizure medications (ASMs), abnormal EEG findings, and delayed immunotherapy were found to be independently associated with the development of epilepsy.
Acute symptomatic seizures are a common manifestation in AE patients. During follow-up, 28.4% of AE patients developed epilepsy. The independent factors that predicted the development of epilepsy after the acute phase included a larger number of ASMs, EEG abnormalities, and delayed immunotherapy. In clinical practice, we should prioritize immunotherapy to control acute seizures as soon as possible. For AE patients with an increased risk of developing epilepsy, early withdrawal of ASM is not recommended.
研究抗 NMDAR、抗 LGI1 和抗 GABABR 脑炎患者急性症状性癫痫发作的临床特征，以及癫痫发生的预测因素。
我们回顾性筛选了 86 例确诊自身免疫性脑炎（AE）住院患者的病历。分析急性症状性癫痫发作的临床特征。采用逻辑回归分析探讨癫痫发生的预测因素。
最终共纳入 86 例 AE 患者。86%的患者（n=74）出现急性症状性癫痫发作，28.4%的患者在随访期间发生癫痫。伴有急性症状性癫痫发作的 AE 患者脑电图异常发现更为频繁。使用抗癫痫药物（ASM）的数量更多、脑电图异常和免疫治疗延迟被发现与癫痫的发生独立相关。
急性症状性癫痫发作是 AE 患者的常见表现。在随访期间，28.4%的 AE 患者发生癫痫。预测急性症状期后癫痫发生的独立因素包括使用更多的 ASM、脑电图异常和免疫治疗延迟。在临床实践中，我们应优先考虑免疫治疗，尽快控制急性癫痫发作。对于有发生癫痫风险增加的 AE 患者，不建议早期停用 ASM。
