LGI1-antibody encephalitis is characterised by frequent, multifocal clinical and subclinical seizures. (August 2017)

• Record Type: Journal Article
• Authors: Aurangzeb, Sidra; Symmonds, Mkael; Knight, Ravi K.; Kennett, Robin; Wehner, Tim; Irani, Sarosh R.
• Is Part Of: Seizure. Volume 50(2017)
• Page Start: 14
• Page End: 17
• Publication Date: 2017-08
• Subjects: Autoimmune encephalitis -- Leucine-rich glioma inactivated-1 -- Autoantibody -- Neuroimmunology -- Epilepsy; Epilepsy -- Periodicals; Epilepsy -- Periodicals; Seizures -- Periodicals; Épilepsie -- Périodiques; Electronic journals; Electronic journals; 616.853
• DOI: 10.1016/j.seizure.2017.05.017
• Languages: English
• ISSNs: 1059-1311

Abstract

Abstract: Purpose: To describe clinical and electrographic characteristics of seizures LGI1-antibody encephalitis, and their correlations with two-year outcomes. Methods: Video-electroencephalography recordings were performed on a cohort of 16 consecutive patients with LGI1-antibodies from two UK neuroscience-centers over five-years. Results: From 14 of 16 patients (13 males; age-range 53–92 years), 86 faciobrachial dystonic seizures were recorded at a median frequency of 0.4 per hour (range 0.1–9.8), and ictal EEG changes accompanied 5/86 events. In addition, 11/16 patients showed 53 other seizures – subclinical (n = 18), motor (n = 16), or sensory (n = 19) – at a median of 0.1 per hour (range 0.1–2) associated with temporal and frontal discharges. The sensory events were most commonly thermal sensations or body-shuddering, and the motor events were frequently automatisms or vocalisations. Furthermore, multifocal interictal epileptiform discharges, from temporal, frontal and parietal regions, and interictal slow-wave activity were observed in 25% and 69% of patients, respectively. Higher observed seizure frequency correlated with poorer functional recovery at two-years (p = 0.001). Conclusions: Multiple frequent seizure semiologies, in addition to numerous subclinical seizures and interictal epileptiform discharges, are hallmarks of LGI1-antibody encephalitis. High overall seizure frequency may predict more limited long-term recovery. These observations should encourage closer monitoring and proactive treatment of seizure activity in these patients.