| Objective:To analyze the clinical characteristics of autoimmune encephalitis(AE)with Neuron-specific autoantibodies(NSAbs)-positive and NSAbs-negative children,explore the risk factors of AE secondary immune-related epilepsy,provide a theoretical basis for the prevention of AE secondary immune-related epilepsy,and guide clinical treatment decisions.Methods:Retrospectively analyzed the data of 48 children with AE treated in our hospital from March 1,2015 to November 30,2022,and divided them into NSAbs-positive group and NSAbs-negative group according to the presence or absence of NSAbs,and compared the clinical characteristics between the two groups.Through outpatient or telephone follow-up,according to whether AE has secondary immune-related epilepsy after 1 year of onset,univariate analysis was performed to compare the clinical characteristics of AE in the acute phase between the two groups,and then perform binary logistic regression analysis on the factors(P<0.05)that had statistical significance to determine the risk factors for independence of AE secondary immunerelated epilepsy.Results:1.There was no significant difference between gender,age,head magnetic resonance imaging,cerebrospinal fluid routine biochemistry,and short-term prognosis between NSAbs-positive AE and NSAbs-negative AE groups(P>0.05),and the proportion of children with NSAbs-negative AE with fever as a prodromal symptom,consciousness disorder,EEG monitoring to clinical/electrical seizures and the number of anti-seizure drugs was higher than that of NSAbs-positive AE,and the difference was statistically significant(P<0.05),and the proportion of movement disorders in NSAbs-positive AE children was higher than that of NSAbs-negative AE,and the difference was statistically significant(P<0.05).2.There were 40 children with AE with more than 1 year follow-up,and 17 cases of AE secondary immune-related epilepsy,accounting for 42.5%.Univariate analysis showed that NSAbs was negative(χ2=13.961,P<0.001),and EEG monitoring of interictal epileptic discharge(χ2=15.140,P<0.001),EEG monitoring of clinical/electrical seizures(χ2=9.337,P=0.002),and the number of anti-seizure drugs(χ2=11.102,P=0.004)were statistically significant(P<0.05),indicating that the above factors were associated with immune-related epilepsy secondary to autoimmune encephalitis;the results of multivariate analysis showed that the effect of NSAbs negative on immune-related epilepsy secondary to autoimmune encephalitis was statistically significant(OR=0.075,95%CI 0.006-0.946,P=0.045),the effect of EEG monitoring of interictal epileptic discharge on immune-related epilepsy secondary to autoimmune encephalitis was statistically significant(OR=22.383,95%CI 2.025-247.411,P=0.012).Conclusion:1.Most of the clinical features of NSAbs-positive AE and NSAbs-negative AE groups are similar,and there are small differences:NSAbs-negative AE is more with fever as a prodromal symptom,consciousness disorder,EEG monitoring to clinical/electrical seizures,and the need to use a variety of anti-seizure drugs,while NSAbs-positive AE has more movement disorders.2.The incidence of AE secondary immunity-related epilepsy was 42.5%at 1 year follow-up,and NSAbs negative and interictal epileptic discharge were risk factors for AE secondary immune-related epilepsy. |
