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Acute Symptomatic Seizures and Risk of Seizure Recurrence in Patients with Anti-NMDAR, Anti-LGI1, and Anti-GABABR Encephalitis

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Abstract

Aims

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.

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Data availability

The raw data supporting the findings of our study is available from the corresponding author upon reasonable request.

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Acknowledgements

We wish to express our gratitude to all the individuals who participated in this study.

Funding

This study received support from the National Natural Science Foundation of China (No.: 81771397).

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Authors and Affiliations

  1. Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China

    Dingge Cui, Jilun Feng, Mu Yang, Yuanyuan Dong & Yajun Lian

Authors
  1. Dingge Cui
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  2. Jilun Feng
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  3. Mu Yang
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  4. Yuanyuan Dong
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  5. Yajun Lian
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Contributions

DG Cui collected the data and drafted the main manuscript. JL Feng, M Yang, and YY Dong collected the data. YJ Lian revised the manuscript and designed the study.

Corresponding author

Correspondence to Yajun Lian.

Ethics declarations

Consent to participate

This study was approved by the Research Ethics Committee of the First Affiliated Hospital of Zhengzhou University (Number:2021-KY-0779-002). Written informed consent to participate was obtained from the patient or his/her legal guardian. This study will not disclose personal information of patients.

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The authors declare no competing interests.

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Cui, D., Feng, J., Yang, M. et al. Acute Symptomatic Seizures and Risk of Seizure Recurrence in Patients with Anti-NMDAR, Anti-LGI1, and Anti-GABABR Encephalitis. Neurol Sci 45, 1609–1617 (2024). https://doi.org/10.1007/s10072-023-07165-1

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  • DOI: https://doi.org/10.1007/s10072-023-07165-1

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