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.
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.
摘要：
目的：我们的研究目的是分析自身免疫性脑炎（AE）患者的特征，以确定与耐药性癫痫（DRE）发展相关的预后因素。
方法：在这项回顾性观察队列研究中，我们纳入了2016年1月至2022年12月的成人AE患者.根据末次随访时是否存在DRE，将患者分为两组。使用逻辑回归分析研究了DRE发展的预测因素。
结果：在121例AE患者中，75.2％（n=91）经历了急性症状性癫痫发作，29.8%(n=36)在末次随访时发展为DRE。在多元回归分析中，与DRE相关的因素是抗体阴性（OR3.628，95％CI1.092-12.050，p=0.035），局灶性癫痫发作（OR6.431，95%CI1.838-22.508，p=0.004），难治性癫痫持续状态（OR8.802，95%CI2.445-31.689，p=0.001），脑电图发作间癫痫样放电（OR6.773，95％CI2.206-20.790，p=0.001），边缘系统T2/FLAIR高强度（OR3.286，95%CI1.060-10.183，p=0.039）。
结论：在这项研究中，发生DRE的风险主要在抗体阴性或局灶性癫痫发作的AE患者中观察到，难治性癫痫持续状态，脑电图上的发作间癫痫样放电，和边缘系统中的T2/FLAIR高强度。
方法：在这项回顾性观察队列研究中，我们纳入了2016年1月至2022年12月的成人AE患者.根据末次随访时是否存在DRE，将患者分为两组。使用逻辑回归分析研究了DRE发展的预测因素。
结果：在121例AE患者中，75.2％（n=91）经历了急性症状性癫痫发作，29.8%(n=36)在末次随访时发展为DRE。在多元回归分析中，与DRE相关的因素是抗体阴性（OR3.628，95％CI1.092-12.050，p=0.035），局灶性癫痫发作（OR6.431，95%CI1.838-22.508，p=0.004），难治性癫痫持续状态（OR8.802，95%CI2.445-31.689，p=0.001），脑电图发作间癫痫样放电（OR6.773，95％CI2.206-20.790，p=0.001），边缘系统T2/FLAIR高强度（OR3.286，95%CI1.060-10.183，p=0.039）。
结论：在这项研究中，发生DRE的风险主要在抗体阴性或局灶性癫痫发作的AE患者中观察到，难治性癫痫持续状态，脑电图上的发作间癫痫样放电，和边缘系统中的T2/FLAIR高强度。
