Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2024 Aug;271(8):5046-5054.
doi: 10.1007/s00415-024-12432-y. Epub 2024 May 27.

Prognostic factors underlying the development of drug-resistant epilepsy in patients with autoimmune encephalitis: a retrospective cohort study

Wenyao Huang #  1 , Heyu Zhang #  1 , Xi Li  1 , Jinming Zhang  1 , Jingjing Chen  1 , Ziyi Chen  2 , Guanzhong Ni  3
Affiliations
Observational Study

Prognostic factors underlying the development of drug-resistant epilepsy in patients with autoimmune encephalitis: a retrospective cohort study

Wenyao Huang et al. J Neurol. 2024 Aug.

Abstract

Objective: The aim of our study was to analyze the characteristics of patients with autoimmune encephalitis (AE) to identify prognostic factors associated with the development of drug-resistant epilepsy (DRE).

Methods: In this retrospective observational cohort study, we enrolled adult patients with AE between January 2016 and December 2022. The patients were categorized into two groups based on the presence or absence of DRE at the last follow-up. The predictors of the development of DRE were investigated using logistic regression analysis.

Results: Among 121 AE patients, 75.2% (n = 91) experienced acute symptomatic seizures, and 29.8% (n = 36) developed DRE at the last follow-up. On multivariate regression analysis, the factors associated with DRE were antibody negativity (OR 3.628, 95% CI 1.092-12.050, p = 0.035), focal seizure (OR 6.431, 95% CI 1.838-22.508, p = 0.004), refractory status epilepticus (OR 8.802, 95% CI 2.445-31.689, p = 0.001), interictal epileptiform discharges on EEG (OR 6.773, 95% CI 2.206-20.790, p = 0.001), and T2/FLAIR hyperintensity in the limbic system (OR 3.286, 95% CI 1.060-10.183, p = 0.039).

Conclusions: In this study, the risk of developing DRE was mainly observed among AE patients who were negative for antibodies or had focal seizures, refractory status epilepticus, interictal epileptiform discharges on EEG, and T2/FLAIR hyperintensity in the limbic system.

Keywords: Acute symptomatic seizures; Autoimmune encephalitis; Drug-resistant epilepsy; Outcome; Prognosis.

PubMed Disclaimer

Similar articles

See all similar articles

References

    1. Britton JW, Dalmau J (2019) Recognizing autoimmune encephalitis as a cause of seizures: treating cause and not effect. Neurology 92:877–878. https://doi.org/10.1212/WNL.0000000000007444 - DOI - PubMed
    1. Yeshokumar AK, Coughlin A, Fastman J et al (2021) Seizures in autoimmune encephalitis—a systematic review and quantitative synthesis. Epilepsia 62:397–407. https://doi.org/10.1111/epi.16807 - DOI - PubMed
    1. Liu X, Guo K, Lin J et al (2022) Long-term seizure outcomes in patients with autoimmune encephalitis: a prospective observational registry study update. Epilepsia 63:1812–1821. https://doi.org/10.1111/epi.17245 - DOI - PubMed
    1. Matricardi S, Casciato S, Bozzetti S et al (2022) Epileptic phenotypes in autoimmune encephalitis: from acute symptomatic seizures to autoimmune-associated epilepsy. J Neurol Neurosur PS. https://doi.org/10.1136/jnnp-2022-329195 - DOI
    1. Steriade C, Britton J, Dale RC et al (2020) Acute symptomatic seizures secondary to autoimmune encephalitis and autoimmune-associated epilepsy: conceptual definitions. Epilepsia 61:1341–1351. https://doi.org/10.1111/epi.16571 - DOI - PubMed

Publication types

Supplementary concepts

LinkOut - more resources