Abstract：
To validate the different predictive scoring scales in the Chinese population with new-onset epileptic seizures or epilepsy of unknown etiology related to neuronal surface antibody (Ab)-mediated autoimmune encephalitis (AE).
We retrospectively reviewed the charts of 174 consecutive patients from October 2018 to December 2022, whose serum and cerebrospinal fluid samples were tested for neuronal surface Abs. The antibody prevalence in epilepsy and encephalopathy (APE2), antibodies contributing to focal epilepsy signs and symptoms (ACES), \"obvious\" indications for neural antibody testing in epilepsy or seizures (ONES) checklist, and the combinations were used to validate the predictive models of neuronal surface Ab-mediated AE.
A total of 139 patients with new-onset epileptic seizures or epilepsy of unknown etiology were enrolled. Abs were detected in 37 patients (26.6%). The APE2/ONES reflex score had the highest sensitivity (89.2%) and lowest specificity (41.7%). The ACES score had the lowest sensitivity (67.5%) and highest specificity (64.7%). Variations in the performance were observed in the different types of AE. 100% of patients with anti-γ-aminobutyric acid B-B receptor encephalitis were predicted by ONES, APE2/ONES reflex, and ACES/ONES reflex scores. Only 75% of patients with anti-N-methyl-D-aspartate receptor encephalitis were predicted by the APE2/ONES and ACES/ONES reflex scores.
Our study was the first to validate various predictive scoring scales in the Chinese cohort of patients with new-onset epileptic seizures or epilepsy of unknown etiology related to neuronal surface Ab-mediated AE. Based upon clinical suspicion, more than one scoring scale should be performed to predict the chance of AE in those patients.
We retrospectively reviewed the charts of 174 consecutive patients from October 2018 to December 2022, whose serum and cerebrospinal fluid samples were tested for neuronal surface Abs. The antibody prevalence in epilepsy and encephalopathy (APE2), antibodies contributing to focal epilepsy signs and symptoms (ACES), \"obvious\" indications for neural antibody testing in epilepsy or seizures (ONES) checklist, and the combinations were used to validate the predictive models of neuronal surface Ab-mediated AE.
A total of 139 patients with new-onset epileptic seizures or epilepsy of unknown etiology were enrolled. Abs were detected in 37 patients (26.6%). The APE2/ONES reflex score had the highest sensitivity (89.2%) and lowest specificity (41.7%). The ACES score had the lowest sensitivity (67.5%) and highest specificity (64.7%). Variations in the performance were observed in the different types of AE. 100% of patients with anti-γ-aminobutyric acid B-B receptor encephalitis were predicted by ONES, APE2/ONES reflex, and ACES/ONES reflex scores. Only 75% of patients with anti-N-methyl-D-aspartate receptor encephalitis were predicted by the APE2/ONES and ACES/ONES reflex scores.
Our study was the first to validate various predictive scoring scales in the Chinese cohort of patients with new-onset epileptic seizures or epilepsy of unknown etiology related to neuronal surface Ab-mediated AE. Based upon clinical suspicion, more than one scoring scale should be performed to predict the chance of AE in those patients.
摘要：
目的：验证与神经元表面抗体（Ab）介导的自身免疫性脑炎（AE）相关的新发癫痫发作或病因不明的癫痫患者的不同预测评分量表。
方法：我们回顾性回顾了2018年10月至2022年12月174例连续患者的图表，对其血清和脑脊液样本进行了神经元表面Abs检测。癫痫和脑病（APE2）中的抗体患病率，导致局灶性癫痫体征和症状（ACES）的抗体，癫痫或癫痫发作（ONES）清单中神经抗体测试的“明显”适应症，和组合用于验证神经元表面Ab介导的AE的预测模型。
结果：共纳入139例新发癫痫发作或病因不明的癫痫患者。在37例患者中检测到Abs（26.6％）。APE2/ONES反射评分敏感性最高(89.2%),特异性最低(41.7%)。ACES评分的敏感性最低（67.5%），特异性最高（64.7%）。在不同类型的AE中观察到性能的变化。100％的抗γ-氨基丁酸B-B受体脑炎的患者被预测的ONES，APE2/ONES反射，和ACES/ONES反射得分。APE2/ONES和ACES/ONES反射评分可预测抗N-甲基-D-天冬氨酸受体脑炎患者中只有75％。
结论：我们的研究首次在中国新发癫痫发作或与神经元表面Ab介导的AE相关的病因不明的癫痫患者队列中验证了各种预测评分量表。基于临床怀疑,应使用一个以上的评分表来预测这些患者的AE几率.
方法：我们回顾性回顾了2018年10月至2022年12月174例连续患者的图表，对其血清和脑脊液样本进行了神经元表面Abs检测。癫痫和脑病（APE2）中的抗体患病率，导致局灶性癫痫体征和症状（ACES）的抗体，癫痫或癫痫发作（ONES）清单中神经抗体测试的“明显”适应症，和组合用于验证神经元表面Ab介导的AE的预测模型。
结果：共纳入139例新发癫痫发作或病因不明的癫痫患者。在37例患者中检测到Abs（26.6％）。APE2/ONES反射评分敏感性最高(89.2%),特异性最低(41.7%)。ACES评分的敏感性最低（67.5%），特异性最高（64.7%）。在不同类型的AE中观察到性能的变化。100％的抗γ-氨基丁酸B-B受体脑炎的患者被预测的ONES，APE2/ONES反射，和ACES/ONES反射得分。APE2/ONES和ACES/ONES反射评分可预测抗N-甲基-D-天冬氨酸受体脑炎患者中只有75％。
结论：我们的研究首次在中国新发癫痫发作或与神经元表面Ab介导的AE相关的病因不明的癫痫患者队列中验证了各种预测评分量表。基于临床怀疑,应使用一个以上的评分表来预测这些患者的AE几率.
