Clinical Observation Of Immunotherapy For Symptomatic Seizures Caused By Encephalitis

Objective:The immunotherapy of patients with symptomatic seizures caused by viral encephalitis and autoimmune encephalitis in the acute phase was compared,and the prognosis of seizures was followed up.Methods:Clinical data of patients with seizures in the acute phase of viral encephalitis and autoimmune encephalitis diagnosed and treated in two tertiary general hospitals in Yunnan Province from June 2010 to April 2018 were retrospectively collected to compare the immunotherapeutic programs used in the acute phase of encephalitis.Seizures and the use of antiepileptic drugs at 6 and 12 months after onset were followed up.The probable factors of seizure prognosis of encephalitis were analyzed by statistical method.Results:A total of 92 eligible patients were included,including 45 patients with viral encephalitis and 47 patients with autoimmune encephalitis.60.0%of the patients with viral encephalitis were treated only with low-dose steroid hormone.63.8%of the patients with autoimmune encephalitis were treated with steroid hormone combined with immunoglobulin,and the steroid hormones were mainly treated with high-dose shock therapy.There was a statistical difference between the two types of immunotherapy regiments(P<0.05).At 6 and 12 months after onset.73.3%and 79.1%of patients with viral encephalitis were seizure freedom.The seizure-free rates of patients with autoimmune encephalitis at two follow-up stages were 76.6%and 90.7%.76.7%of viral encephalitis and 74.4%of autoimmune encephalitis had stopped taking antiepileptic drugs and no seizures had reoccurred at 12 months after onset.Fever at acute stage of viral encephalitis was a risk factor for poor prognosis of epileptic seizures 6 months after the onset(P=0.026).Seizure prognosis of autoimmune encephalitis was associated with immunotherapeutic strategy at acute stage(P<0.05).The patients treated with combined steroid hormone and immunoglobulin had better prognosisConclusion:Immunotherapy may improve seizure prognosis of patients with acute encephalitis.Viral encephalitis can be treated with low-dose hormones in the acute phase,and hormone combined with immunoglobulin therapy is recommended for autoimmune encephalitis.