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• W2561188233 abstract "OBJECTIVE: Analyze clinical and electrographic characteristics of patients with autoimmune epilepsy and evaluate the effect of immunomodulatory therapy on reduction of seizure frequency. BACKGROUND: No management guidelines for autoimmune epilepsy exist. Common treatment strategies include optimizing antiepileptic drugs, treatment of underlying malignancy, and use of immunomodulatory agents. DESIGN/METHODS: Observational retrospective case series, conducted using electronic medical data from two teaching hospitals. Clinical data was collected from 2008 to 2013. Cases were selected based on pre-specified inclusion and exclusion criteria. RESULTS: 34 patients with predominant seizure presentation and concern for autoimmune etiology were identified. Mean age of study participants was 44.94 years and 64.7[percnt] were males. Autoimmune antibodies were detected in 76.5[percnt](26) of patients; VGKc 23.5[percnt](8); NMDA-R 20.6[percnt](7); anti-thyroid 14.7[percnt](5); GAD 11.8[percnt](4); GABAB 5.9[percnt](2). Electrographic seizures were documented in 85.3[percnt](29) of patients: 22 unilateral temporal, 4 bilateral temporal and 8 extra-temporal onset. 79.4[percnt] patients had inter-ictal discharges. 29.4[percnt] patients had electrographic seizures with no clinical correlate, 44.1[percnt] patients were discovered to have focal status epilepticus. Mean daily seizures during initial prolonged EEG monitoring were 4.00 (SD 7.59); average number of anti-seizure drugs used was 2.35 (SD 1.15). 26.4[percnt] of patients had an underlying malignancy. 94.1[percnt] (32) patients received immunomodulation, including steroids (88.2[percnt]), plasmapheresis (58.8[percnt]), IVIG (32.4[percnt]), rituximab (23.5[percnt]), mycophenolate (14.7[percnt]) and cyclophosphamide (11.8[percnt]). 63.3[percnt] (19) participants achieved 蠅50[percnt] seizure reduction at first clinic follow-up (mean duration: 52.62 days). There was no outcome difference based on gender, race, age, hospital location, presenting symptom, or type of antibody. Patients without malignancy had better seizure control (p<0.05). Time from symptom onset to diagnosis (p<0.005) and symptom onset to immunomodulation (p <0.005) was significantly lower among patients who achieved 蠅50[percnt] seizure reduction. CONCLUSIONS: This study highlights certain important clinical, electrographic aspects of autoimmune epilepsy and significance of early diagnosis and initiation of immunomodulatory therapy. Disclosure: Dr. Hays has nothing to disclose. Dr. Samudra has nothing to disclose. Dr. Samudra has nothing to disclose. Dr. Agostini has nothing to disclose. Dr. Ding has nothing to disclose. Dr. Gupta has nothing to disclose. Dr. Van Ness has received personal compensation in an editorial capacity for Archives of Neurology. Dr. Vernino has received personal compensation for activities with Chelsea Therapeutics as an advisory board participant. Dr. Vernino has received personal compensation in an editorial capacity for JAMA Neurology. Dr. Vernino has receive license fee payme" @default.
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• W2561188233 date "2015-04-06" @default.
• W2561188233 modified "2023-09-25" @default.
• W2561188233 title "Autoimmune Epilepsy: Clinical Features, Management and Outcomes (P6.285)" @default.
• W2561188233 hasPublicationYear "2015" @default.
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