Status epilepticus associated with acute encephalitis: long‐term follow‐up of functional and cognitive outcomes in 72 patients

Chen, Weibi; Su, Yingying; Jiang, Mengdi; Liu, G.; Tian, Fei; Ren, Guoping

doi:10.1111/ene.13678

Cited by 13 publications

(16 citation statements)

References 24 publications

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“…38 Another study looked at 17 patients with SE caused by AIE compared with patients with SE caused by viral encephalitis. 39 Those with AIE had worse cognitive (on the modified Telephone Interview for Cognitive Status) and functional outcomes (modified Rankin Scale) compared to those with viral encephalitis. 39…”

Section: Discussionmentioning

confidence: 91%

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Seizures in autoimmune encephalitis: Kindling the fire

et al. 2020

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Epilepsy affects at least 45.9 million adults worldwide, and hence poses an enormous global socioeconomic burden. 1 Poorly controlled or uncontrolled seizures in the setting of epilepsy can have important implications for the individual, including cognitive, psychiatric, and physical morbidity, with an overall poor quality of life and associated increased risk of mortality, including sudden death. 2 Autoimmune diseases of the central nervous system (CNS) are increasing in prevalence in the community. 3 Seizures can be a common presentation of autoimmune encephalitis (AIE). 4 Termed "autoimmune seizures" or "autoimmune epilepsy," these disorders are thought to be immune-mediated. 4 Recognition of the importance of autoimmune seizures has provided impetus to understand their biological basis. The interaction between the immune system, neuroinflammation, and epileptogenesis likely holds the key to unlocking the pathogenesis of autoimmune seizures. | AUTOIMMUNE ENCEPHALITIS | OverviewThe AIEs are a collection of immune-mediated disorders targeting the CNS. 5 These disorders can present with a broad range of neurological symptoms, particularly seizures, cognitive

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Section: Discussionmentioning

confidence: 91%

“…39 Those with AIE had worse cognitive (on the modified Telephone Interview for Cognitive Status) and functional outcomes (modified Rankin Scale) compared to those with viral encephalitis. 39…”

Section: Discussionmentioning

confidence: 91%

Seizures in autoimmune encephalitis: Kindling the fire

et al. 2020

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“…In addition to involving the anti-GABA B R antibody, our result shows that patients with SE, cortical abnormalities in MRI, and focal neurological dysfunction are more likely to develop worse outcomes than those who did not accompany these findings. SE has been proven to be an independent risk factor in major types of epilepsy (33, 34). The complications of SE, such as severe pneumonia and ICU admission, have also contributed to poor outcomes (5).…”

Section: Discussionmentioning

confidence: 99%

Characteristics of Seizure and Antiepileptic Drug Utilization in Outpatients With Autoimmune Encephalitis

Huang

Wei

et al. 2019

Front. Neurol.

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Autoimmune encephalitis (AE) is one kind of encephalitis that associates with specific neuronal antigens. Most patients with AE likely suffer from seizures, but data on the characteristics of seizure and antiepileptic drugs (AEDs) utilization in this patient group remains limited. This study aimed to report the clinical status of seizure and AEDs treatment of patients with AE, and to evaluate the relationship between AEDs discontinuation and seizure outcomes. Patients with acute neurological disorders and anti-N-methyl-D-aspartate receptor (NMDAR), γ-aminobutyric acid B receptor (GABABR), leucine-rich glioma inactivated 1, or contactin-associated protein-like 2 (CASPR2) antibodies were included. As patients withdrew from AEDs, they were divided into the early withdrawal (EW, AEDs used ≤3 months) and late withdrawal (LW, AEDs used >3 months) groups. Seizure remission was defined as having no seizures for at least 1 year after the last time when AEDs were administered. Seizure outcomes were assessed on the basis of remission rate. The factors affecting the outcomes were assessed through Spearman analysis. In total, we enrolled 75 patients (39 patients aged <16 years, male/female = 39/36) for follow-up, which included 67 patients with anti-NMDAR encephalitis, 4 patients with anti-GABABR encephalitis, 2 patients with anti-voltage-gated potassium channel encephalitis, and 2 patients with coexisting antibodies. Among the 34 enrolled patients with anti-NMDAR encephalitis who were withdrawn from AEDs, only 5.8% relapse was reported during the 1-year follow-up, with no significant difference in the percentage of relapse between the EW and LW groups (P = 0.313). Fifteen patients (an average age of 6.8, 14 patients with anti-NMDAR encephalitis and 1 patient with anti-CASPR2 encephalitis) presented seizure remission without any AEDs. Seventy five percent of patients with anti-GABABR antibodies developed refractory seizure. Other risk factors which contributed to refractory seizure and seizure relapse included status epilepticus (P = 0.004) and cortical abnormalities (P = 0.028). Given this retrospective data, patients with AE have a high rate of seizure remission, and the long-term use of AEDs may not be necessary to control the seizure. Moreover, seizures in young patients with anti-NMDAR encephalitis presents self-limited. Patients with anti-GABABR antibody, status epilepticus, and cortical abnormalities are more likely to develop refractory seizure or seizure relapse.

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“…patients with seizures, focal neurological deficit and electroencephalographic slowing qualified for inclusion, but this constellation might also be encountered in other conditions, such as stroke). Not all included patients met the widely used definition of RSE [3]; resistance to two consecutive benzodiazepines, as considered in the study, would not correspond to being refractory to two different antiepileptic drugs in most centers. Also, the precise work-up of viral or autoimmune etiologies is not reported and 12 out of 84 survivors were lost to follow-up, which may lead to overestimation of the good outcome.…”

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confidence: 99%

“…This issue of European Journal of Neurology contains a retrospective study by Chen and colleagues on the functional outcome at 12 months of 72 patients with SE of inflammatory origin [3]. The methodology has some limitations.…”

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confidence: 99%

Status epilepticus due to acute encephalitis: NORSE does not necessarily mean worse

Holzer¹,

Rossetti

2018

Euro J of Neurology

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Status epilepticus associated with acute encephalitis: long‐term follow‐up of functional and cognitive outcomes in 72 patients

Abstract: Survival with favorable functional recovery was promising after prolonged RSE in patients with acute encephalitis.

Cited by 13 publications

References 24 publications

Seizures in autoimmune encephalitis: Kindling the fire

Seizures in autoimmune encephalitis: Kindling the fire

Characteristics of Seizure and Antiepileptic Drug Utilization in Outpatients With Autoimmune Encephalitis

Status epilepticus due to acute encephalitis: NORSE does not necessarily mean worse

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