Analysis Of Influencing Factors Of Symptomatic Seizures In Anti-neuronal Antibody-positive Autoimmune Encephalitis

Background and purposeAutoimmune Encephalitis(AE)is an autoimmune disease involving the central nervous system.The clinical manifestations of AE are complex and varied,which mainly include abnormal mental behavior,seizures,and cognitive function decline,etc.The seizures in the acute stage of AE is common,and it is not rare to have a relapse after treatment.The seizures frequency and influencing factors in the acute phase of AE and post-AE are mainly discussed here,and looking for factors that may contribute to the development of epilepsy.In order to help patients develop a better treatment plan and avoid the transformation of seizures in the acute stage of AE into epilepsy.MethodsEighty AE patients with positive antibodies against cell surface and synaptic proteins were included,and their clinical data were collected for retrospective analysis and clinical follow-up observation,in order to find the influencing factors of seizures in the acute and non-acute stages of AE.According to the types of CSF autoimmune antibodies included in AE patients,the patients were divided into different groups.ResultsThere were 80 cases of AE with positive antibodies,including 28 cases of anti-NMDAR encephalitis(35%),27 cases of anti-LGI1 encephalitis(33.75%),14cases of anti-GABA_BR encephalitis(17.5%),and 11 cases of other positive antibodies(13.75%).In the acute stage,57 patients(71.25%)had seizures and 23 patients(28.75%)did not have seizures.The 80 patients were followed up,5 of whom were lost to follow-up,and 75 of whom were in the non-acute phase,including 21(28%)with seizures and 54(72%)without seizures.Impairment of consciousness(OR=86.234(6.096,1219.928)),anti-LGI1 encephalitis,anti-GABAB encephalitis,and other antibody types of encephalitis have a higher risk of acute seizures than anti-NMDR encephalitis in the acute stage(P<0.05).Increased CSF cell count(OR=3.636(1.221,10.830))and lung infection(OR=3.167(1.116,8.987))were high-risk influencing factors for non-acute seizures after AE treatment(P<0.05).ConclusionsImpairment of consciousness,anti-LGI1 encephalitis,anti-GABAB encephalitis,and other antibody types of encephalitis have a higher risk of acute seizures than anti-NMDR encephalitis in the acute stage(P<0.05).Increased CSF cell count and lung infectionwere high-risk influencing factors for non-acute seizures after AE treatment(P<0.05).Timely treatment of lung infection and anti-epilepsy may reduce the frequency of seizures in acute stage of AE.Timely termination of the status epilepticus can help to reduce seizures and clinical adverse consequences.Although the recurrence rate of AE patients is high,most of them have a good prognosis,and a small number of patients will leave neurological deficiency symptoms,affecting the quality of life,and even death.