Shen Chun-Hong, Ming Wen-Jie, Zhang Yin-Xi, Cai Meng-Ting, Du Bin-Qing, Du Ye, Xu Yong-Feng, Wang Zhong-Jin, Guo Yi, Ding Yao, Xu Sha, Hu Yin, Zhang Xue-Mei, Wang Shuang, Ding Mei-Ping
Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China; Epilepsy Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China.
Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China.
Clin Neurophysiol. 2025 Jul;175:2110753. doi: 10.1016/j.clinph.2025.2110753. Epub 2025 May 17.
To delineate seizure and electroencephalographic (EEG) characteristics in a cohort of patients with anti-leucine-rich glioma-inactivated 1 (LGI1) encephalitis.
Sixty-six newly diagnosed anti-LGI1 encephalitis patients with seizures were consecutively recruited. EEG data was obtainable for 63 patients, including 24-hour video EEG (VEEG) for 35 participants. Demographics, seizure characteristics, EEG findings, and general clinical data were reviewed.
Among 66 patients, facial brachial dystonic seizures (FBDS), focal non-FBDS seizures, and secondarily generalized tonic-clonic seizures (sGTCS) occurred in 27.3 %, 59.1 %, and 57.6 %, respectively. Piloerection was observed in 27.3 %, and daily focal seizures were reported in 74.2 %. Sex-related analysis indicated females exhibited younger onset age with higher prevalence of focal non-FBDS seizures, piloerection, and daily seizures, whereas males had more sGTCS and cerebrospinal fluid abnormalities (p < 0.05). Interictal EEG revealed excessive beta activity (EBA) in 40.0 %, interictal epileptiform discharges in 22.2 %, and rhythmic delta activity in 12.7 %. Quantitative analysis provided confirmation of EBA. VEEG captured clinical events in 48.6 % and subclinical seizures (SCS) in 20.0 %.
We highlight seizure characteristics in anti-LGI1 encephalitis, particularly piloerection, daily focal seizures, and sex-related differences. Beyond previously reported SCS, EBA appears to be a frequent EEG pattern.
These findings may facilitate the recognition of anti-LGI1 encephalitis.
描述一组抗富含亮氨酸胶质瘤失活1（LGI1）脑炎患者的癫痫发作及脑电图（EEG）特征。
连续纳入66例新诊断的伴有癫痫发作的抗LGI1脑炎患者。63例患者可获取EEG数据，其中35例患者进行了24小时视频脑电图（VEEG）检查。回顾了患者的人口统计学资料、癫痫发作特征、EEG表现及一般临床数据。
66例患者中，面臂肌张力障碍性发作（FBDS）、局灶性非FBDS发作和继发性全面强直阵挛发作（sGTCS）分别占27.3%、59.1%和57.6%。27.3%的患者出现竖毛现象，74.2%的患者报告有每日局灶性发作。性别相关分析表明，女性发病年龄较轻，局灶性非FBDS发作、竖毛现象和每日发作的患病率较高，而男性的sGTCS和脑脊液异常更多（p<0.05）。发作间期EEG显示，40.0%的患者有β活动增多（EBA），22.2%的患者有发作间期癫痫样放电，12.7%的患者有节律性δ活动。定量分析证实了EBA的存在。VEEG捕捉到48.6%的临床事件和20.0%的亚临床发作（SCS）。
我们强调了抗LGI1脑炎的癫痫发作特征，特别是竖毛现象、每日局灶性发作和性别差异。除了先前报道的SCS外，EBA似乎是一种常见的EEG模式。
这些发现可能有助于抗LGI1脑炎的识别。
