Treatment Outcome of Autoimmune Associated Epilepsy (AAE) vs Acute Symptomatic Seizures in Autoimmune Encephalitis (ASSAE)–A Single Center Experience

Objective To assess the seizure treatment outcome in autoimmune encephalitis (AE). Background Seizures due to AE etiology are increasingly recognized. Timely confirmation of may lead improved outcomes by allowing for earlier immunotherapy, which is more effective than anti-seizure medication (ASM). Currently, seizures/epilepsy can be subcategorized as associated epilepsy or acute symptomatic seizures with varied response immunotherapy. Design/Methods This was a retrospective single center study including patients diagnosed AE, minimum follow-up 12 months after disease onset alive cases. Results 28 out 31 were analyzed (3 without excluded). found have autoantibodies (Abs) against cell membrane (CM) protein anti-NMDAR, 4 anti-GABAbR, anti-LGI-1, 1 anti-GABAaR); non-specific Abs (low titer anti-GAD, VGCC); 11 no identified; 3 intracellular (IC) (MOG, Hu, GFAP). All received immunotherapy and ASM treatment. Among CM-Abs, 10 remained free, 7 successfully weaned off ASM. those nonspecific/no Abs, only 15 (26.7%) free. did poorly, one patient anti-MOG-Abs survived drug resistant (DRE). Within group 2 (16.7%) anti-GABAbR-Abs developed DRE, compared over 70% IC-Abs. Upon further investigation DRE patients, several features observed: 1) poor 2) sustained abnormal brain MRI T2/FLAIR signal, 3) persistent focal epileptiform frequent ictal patterns EEGs. Conclusions Patients CM-Abs likely suffer ASSAE favorable long-term outcome. identified auto-Abs IC-Abs develop AAE consequently DRE. Further research focusing on biomarkers predicting needed guidance.