149  Mesial temporal lobe epilepsy with amygdala enlargement: a phenotype of autoimmune epilepsy?. Issue 6 (27th May 2022)

• Record Type: Journal Article
• Authors: Glasse, Hannah; Hotchkies, Angus; Bailey, Matt; Mohanraj, Rajiv; Cahill, Varduhi; Cooper, Paul
• Is Part Of: Journal of neurology, neurosurgery and psychiatry. Volume 93:Issue 6(2022)
• Page Start: A55
• Page End: A56
• Publication Date: 2022-05-27
• Subjects: Neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; Psychiatry -- Periodicals; 616.8
• DOI: 10.1136/jnnp-2022-ABN.179
• Languages: English
• ISSNs: 0022-3050

Abstract

Abstract : Background: Mesial temporal lobe epilepsy with amygdala enlargement (MTLE-AE) is a relatively newly described subtype of focal epilepsy. The aetiology of MTLE-AE remains unclear. We investigated the prevalence of antibodies to neuronal antigens in a cohort of adult patients with MTLE-AE Methods: Patients with MTLE-AE presenting to a tertiary epilepsy clinic were identified. Demographic and characteristic data were collected by review of records. The antibody prevalence in epilepsy (APE2) score was calculated for all patients. Results: 25 cases of TLE-AE who had undergone antibody testing were identified. 5 cases had positive antibodies (2 VGKC+LGI-1, 1 VGKC alone, 2 GAD). Mean age of epilepsy onset was 46.2 and 35.4 years for antibody positive and negative groups respectively. The antibody positive group had a higher mean APE2 score (6) than the negative group (3.8), partially due to a higher incidence of neuropsychiatric features and prodromal illness. All VGKC positive patients achieved seizure freedom with immunotherapy. Discussion: MTLE-AE may be related to autoimmune processes in a proportion of cases. This potentially treatable cause may be missed in patients with epilepsy, if antibody testing is not undertaken. [e-mail]