Seizure Characteristics and Seizure Outcomes in Pediatric Autoimmune Encephalitis
Abstract number :
1.233
Submission category :
4. Clinical Epilepsy / 4D. Prognosis
Year :
2021
Submission ID :
1826494
Source :
www.aesnet.org
Presentation date :
12/4/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:54 AM
Authors :
Hyewon Woo, MD - Seoul National University Children's Hospital; YoungKye Shim - Korea University Ansan Hospital; Soo Yeon Kim - Seoul National University Children's Hospital; Anna Cho - Bundang Seoul National University Hospital; Hunmin Kim - Bundang Seoul National University Hospital; Hee Hwang - Bundang Seoul National University Hospital; Jong-Hee Chae - Seoul National University Children's Hospital; Jieun Choi - Seoul National University Boramae Medical C; Ki Joong Kim - Seoul National University Children's Hospital; Byung Chan Lim - Seoul National University Children's Hospital
Rationale: Seizures are a common symptom of autoimmune encephalitis (AE). This study investigated seizure characteristics and seizure outcomes according to the autoantibodies in pediatric AE.
Methods: The 106 patients satisfying revised diagnostic criteria of pediatric AE were enrolled. Three groups were recognized based on the presence of auto antibody: anti-myelin oligodendrocyte glycoprotein antibody (anti-MOG), anti-N-methyl-D-aspartate receptor (anti-NMDAR) antibody, and seronegative AE. The seizure characteristics, treatment, and seizure outcomes were reviewed. Seizure outcome was evaluated in patients who had recurrent seizures.
Results: Of 106 patients, 38.6% (17/44) of anti-MOG, 88.0% (22/25) of anti-NMDAR, and 73.0% (27/37) of seronegative AE had seizures during the disease course. The proportion of patients with only single seizure was 35.2% (6/17) in anti-MOG, 13.6% (3/22) in anti-NMDAR, and 11.1% (3/27) in seronegative group. Status epilepticus occurred in 6 (35.3%) with anti-MOG, 6 (27.3%) with anti-NMDAR, and 14 (51.9%) with seronegative AE. Antiepileptic drugs were used in 8 (47.1%) of anti-MOG, 20 (90.9%) of anti-NMDAR, and 25 (92.6%) of seronegative AE patients. First-line immunotherapy was given in 11 (64.7%) with anti-MOG, 22 (100%) with anti-NMDAR, and 20 (74.1%) with seronegative AE. Second-line immunotherapy was performed in 17 (77.3%) with anti-NMDAR and 3 (11.1%) with seronegative AE. The proportion of patients with seizure free at 6 months follow-up was lower in seronegative AE (13/21, 61.9%) compared with anti-MOG (9/9, 100%) and anti-NMDAR (14/16, 87.5%). The similar trend of seizure outcome was suggested at 12 months follow-up: anti-MOG (6/6, 100%), anti-NMDAR (10/13, 76.9%), and seronegative AE (10/16, 62.5%). Seizure relapse after more than 12 months seizure-free period occurred in 2 with anti-MOG, 1 with anti-NDMAR, and 6 in seronegative AE.
Conclusions: Seronegative AE seemed to be associated with less favorable seizure outcome compared with anti-MOG and anti-NMDAR encephalitis.
Funding: Please list any funding that was received in support of this abstract.: I have no relevant financial relationships to disclose.
Clinical Epilepsy