Abstract：
OBJECTIVE: To analyze the clinical characteristics of acute symptomatic seizures and predict the risk factors for seizure recurrence in patients with anti-N-methyl-D-aspartate receptor (NMDAR), anti-leucine-rich glioma-inactivated 1 (LGI1), and anti-gamma-aminobutyric acid B receptor (GABABR) encephalitis.
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.
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.
摘要：
目的：分析抗N-甲基-D-天门冬氨酸受体（NMDAR）患者急性症状性癫痫的临床特点，并预测癫痫复发的危险因素。抗富亮氨酸胶质瘤灭活1（LGI1），和抗γ-氨基丁酸B受体（GABABR）脑炎。
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。
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。
