Prevalence, risk factors, and prognosis of drug-resistant epilepsy in autoimmune encephalitis.

Abstract

OBJECTIVE:

To evaluate the prevalence and biomarkers of drug-resistant epilepsy (DRE) in patients with autoimmune encephalitis (AIE).

METHODS:

Sixty-nine patients with AIE were recruited retrospectively and electroencephalographies (EEGs) were reviewed using a standard reporting proforma. Associations between EEG biomarkers and DRE development at 12 months were examined using logistic regression modeling and were utilized to create a DRE risk score.

RESULTS:

Sixteen percent of patients with AIE developed DRE at 12-month follow-up. The presence of status epilepticus (SE) (OR 11.50, 95% CI [2.81, 51.86], p-value <0.001), temporal lobe focality (OR 9.90, 95% CI [2.60, 50.71], p-value 0.001) and periodic discharges (OR 19.12, 95% CI [3.79, 191.10], p-value 0.001) on the admission EEG were associated with the development of DRE at 12 months. These variables were utilized to create a clinically applicable risk score for the prediction of DRE development.

CONCLUSIONS:

Drug-resistant epilepsy is an infrequent complication of AIE. Electroencephalography changes during the acute illness can predict the risk of DRE at 12 months post-acute AIE.

SIGNIFICANCE:

The identified EEG biomarkers provide the basis to generate a clinically applicable prediction tool which could be used to inform treatment, prognosis, and select patients for acute treatment trials.

• Authors: Robb Wesselingh, James Broadley, Katherine Buzzard, David Tarlinton, Udaya Seneviratne, Chris Kyndt, Jim Stankovich, Paul Sanfilippo, Cassie Nesbitt, Wendyl D'Souza, Richard Macdonell, Helmut Butzkueven, Terence J O'Brien, Mastura Monif
• Journal: Epilepsy & behavior : E&B (Epilepsy Behav) Vol. 132 Pg. 108729 (07 2022) ISSN: 1525-5069 [Electronic] United States
• PMID: 35623203 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2022 Elsevier Inc. All rights reserved.

Chemical References

• Biomarkers

Topics

• Biomarkers
• Drug Resistant Epilepsy (diagnosis, epidemiology, etiology)
• Electroencephalography (adverse effects)
• Encephalitis (complications, epidemiology)
• Hashimoto Disease
• Humans
• Prevalence
• Prognosis
• Retrospective Studies
• Risk Factors