ArticleJournal of neurology2021
Seizures associated with antibodies against cell surface antigens are acute symptomatic and not indicative of epilepsy: insights from long-term data.
Article in Journal of neurology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed, 44 citations in OpenAlex.
- Risk of Epilepsy and Factors Associated With Time to Seizure Remission in Anti-LGI1 Encephalitis: Long-Term Outcome in 236 Patients.Neurology(R) neuroimmunology & neuroinflammation · 2025Observational
- Autoimmune polyglandular syndrome and GAD65 related-temporal lobe epilepsy.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Article
- Autoimmune encephalitis.Nature reviews. Disease primers · 2025Review
- Temporal Lobe Epilepsy Associated With Glutamic Acid Decarboxylase Antibodies: Defining a Distinct Epilepsy Syndrome.Neurology(R) neuroimmunology & neuroinflammation · 2025Article
- The limbic and extra-limbic encephalitis associated with glutamic acid decarboxylase (GAD)-65 antibodies: an observational study.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Observational
- Autoimmune encephalitis-associated epilepsy.Nature reviews. Neurology · 2025Review
- Review
- Seizures and status epilepticus in anti-NMDA receptor encephalitis.Journal of neurology · 2025Article
- Clinical Characteristics and Seizure Outcomes in Antibody-Positive Autoimmune Limbic Encephalitis.Journal of inflammation research · 2025Article
- LGI1 encephalitis: potentially complement-activating anti-LGI1-IgG subclasses 1/2/3 are associated with the development of hippocampal sclerosis.Journal of neurology · 2024Article
- Risk of Seizure Recurrence Due to Autoimmune Encephalitis With NMDAR, LGI1, CASPR2, and GABANeurology(R) neuroimmunology & neuroinflammation · 2024Article
- Predictive value of persistent antibodies at 6 months for relapse in neuronal surface antibody-associated autoimmune encephalitis.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2024Article
- Predictors of seizure outcomes of autoimmune encephalitis: A clinical and morphometric quantitative analysis study.Clinical neurology and neurosurgery · 2023Article
- Immune Mechanisms in Epileptogenesis: Update on Diagnosis and Treatment of Autoimmune Epilepsy Syndromes.Drugs · 2023Review
- Use of anti-seizure medications in different types of autoimmune encephalitis: A narrative review.Frontiers in neurology · 2023Review
- Long-term evolution and prognostic factors of epilepsy in limbic encephalitis with LGI1 antibodies.Journal of neurology · 2022Article
- Do the neurologists recognize autoimmune epilepsy well enough? What is the effect of the pandemic on this matter?Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2022Article
- Prevalence of Neural Autoantibodies in Epilepsy of Unknown Etiology: Systematic Review and Meta-Analysis.Brain sciences · 2021Review
Corrections and comments
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Authors and funding
14 authors at 9 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundClinicians have questioned whether any disorder involving seizures and neural antibodies should be called "(auto)immune epilepsy." The concept of "acute symptomatic seizures" may be more applicable in cases with antibodies against neural cell surface antigens. We aimed at determining the probability of achieving seizure-freedom, the use of anti-seizure medication (ASM), and immunotherapy in patients with either constellation. As a potential pathophysiological correlate, we analyzed antibody titer courses.
methodsRetrospective cohort study of 39 patients with seizures and neural antibodies, follow-up ≥ 3 years.
resultsPatients had surface antibodies against the N-methyl-D-aspartate receptor (NMDAR, n = 6), leucine-rich glioma inactivated protein 1 (LGI1, n = 11), contactin-associated protein-2 (CASPR2, n = 8), or antibodies against the intracellular antigens glutamic acid decarboxylase 65 kDa (GAD65, n = 13) or Ma2 (n = 1). Patients with surface antibodies reached first seizure-freedom (88% vs. 7%, P < 0.001) and terminal seizure-freedom (80% vs. 7%, P < 0.001) more frequently. The time to first and terminal seizure-freedom and the time to freedom from ASM were shorter in the surface antibody group (Kaplan-Meier curves: P < 0.0001 for first seizure-freedom; P < 0.0001 for terminal seizure-freedom; P = 0.0042 for terminal ASM-freedom). Maximum ASM defined daily doses were higher in the groups with intracellular antibodies. Seizure-freedom was achieved after additional immunotherapy, not always accompanied by increased ASM doses. Titers of surface antibodies but not intracellular antibodies decreased over time.
conclusionSeizures with surface antibodies should mostly be considered acute symptomatic and transient and not indicative of epilepsy. This has consequences for ASM prescription and social restrictions. Antibody titers correlate with clinical courses.
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