Clinical Analysis Of 14 Cases Of Autoimmune Encephalitis With Epileptic Seizures

Objective To explore the treatment methods of intractable status epilepticus and super-intractable status epilepticus in patients with autoimmune encephalitis,we analyzed the clinical characteristics of patients with autoimmune encephalitis with epileptic seizures and the therapeutic effect of anti-epilepsy.What's more,we also want to improve the understanding and treatment level of neurologists for epileptic seizures in patients with autoimmune encephalitis through these exploring.Methods General clinical features,clinical manifestations,types of epilepsy,biochemical and CBC results,tumor screening,cerebrospinal fluid,electroencephalogram,craniocerebral MRI and anti-epilepsy regimen of patients with autoimmune encephalitis with epilepsy were collected from January 2016 to January 2019 from the General Hospital of Ningxia medical university.In combination with domestic and foreign literatures,analyze comprehensively,discuss the clinical characteristics and anti-epileptic treatment of epilepsy with autoimmune diseases.Results The incidence of epilepsy in AE patients was about 82.35%(14/17).Among 14 AE patients with epilepsy,21.42% were younger than 20 years old,50.00% were between 20 and 40 years old(including 40 years old),14.29% were between 40 and 60 years old(including 60 years old),14.29% were older than 60 years old.And 85.72% of patients with seizures occurred within 2 weeks(W)after AE onset,7.14% appeared at 2W ~ 4W,and 7.14% appeared after 4W,and the first symptom of epilepsy was 42.86%.Of the 14 patients with AE,3(21.43%)had only one type of seizure,5(35.71%)had 2 seizure types,5(35.71%)had 3 seizure types,and 1(7.14%)had 4 types of seizures.What's more,5(35.71%)patients were with partial partial seizures,7 patients were with complex partial seizures(50.00%),and 6 patients(42.86%)were with partial seizures followed by generalized seizures,13(92.86%)were with a full-bodied-clonic attack.85.71% of the 14 patients showed persistent status of epilepsy,of which 58.33%(7/12)showed persistent refractory epilepsy Status,25.00%(3/12)manifested as super-refractory status epilepticus.In terms of the treatment plan,14 patients were given immune shock and anti-epileptic drugs,2 patients with non-epileptic status were completely controlled,and 12 patients with epilepsy status were controlled with a total effective rate of 91.67%,of which 2 patients were completely controlled(16.67%),9 cases(75.00%)were effective controllers,and 1 patient was ineffective(8.33%).Conclusion 1.Patients with autoimmune encephalitis are prone to epileptic seizures within 2 weeks of onset.The most common type of seizures is generalized tonic-clonic seizures.2.Patients with autoimmune encephalitis are prone to secondary status epilepticus,and most of them are effective after immunotherapy and antiepileptic drugs.