METHODS: In this retrospective study, we included hospitalized patients who had been diagnosed with anti-NMDAR, anti-LGI1, and anti-GABABR encephalitis between November 2014 and April 2021. Binary logistic regression analysis was performed to identify the potential risk factors for seizure recurrence.
RESULTS: In total, 262 patients with anti-NMDAR, anti-LGI1, and anti-GABABR encephalitis were included, 197 (75.2%) of whom presented with acute symptomatic seizures. During follow-up, 42 patients exhibited seizure recurrence. In anti-NMDAR encephalitis, frontal lobe abnormality on brain magnetic resonance imaging, delayed immunotherapy, early seizures, and focal motor onset were associated with seizure recurrence.
CONCLUSIONS: Acute symptomatic seizure is a common clinical feature observed in patients with anti-NMDAR, anti-LGI1, and anti-GABABR encephalitis, with 50% of patients presenting with seizures as an initial symptom. The prognosis of patients with acute symptomatic seizures can be improved after receiving immunotherapy. Nevertheless, a minority of patients will experience seizure recurrence; therefore, restarting immunotherapy is recommended.
方法:在这项回顾性研究中,我们纳入了被诊断患有抗NMDAR的住院患者,2014年11月至2021年4月之间的抗LGI1和抗GABABR脑炎。进行二元logistic回归分析以确定癫痫复发的潜在危险因素。
结果:总计,262例抗NMDAR患者,包括抗LGI1和抗GABABR脑炎,197例(75.2%)患者出现急性症状性癫痫发作。随访期间,42例患者出现癫痫发作复发。在抗NMDAR脑炎中,脑磁共振成像的额叶异常,延迟免疫疗法,早期癫痫发作,和局灶性运动发作与癫痫发作复发有关。
结论:急性症状性癫痫发作是抗NMDAR患者的常见临床特征,抗LGI1和抗GABABR脑炎,50%的患者以癫痫发作为初始症状。急性症状性癫痫患者接受免疫治疗后可改善预后。然而,少数患者会出现癫痫发作复发;因此,建议重新启动免疫疗法。