Bilateral tonic-clonic seizures and status epilepticus in autoimmune encephalitis

Background. Epileptic seizures are involved in the diagnostic criteria for autoimmune encephalitis (AE). In this regard, timing of onset of focal-to-bilateral tonic-clonic seizure (BTCS) transition and status epilepticus (SE) in AE is understudied.Objective: to compare the timing of onset for focal-...

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Main Authors: M. Yu. Maximova, E. A. Golovneva, A. G. Broutian, E. O. Chekanova, M. N. Zakharova
Format: Article
Language:Russian
Published: IRBIS LLC 2025-05-01
Series:Эпилепсия и пароксизмальные состояния
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Online Access:https://www.epilepsia.su/jour/article/view/1186
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author M. Yu. Maximova
E. A. Golovneva
A. G. Broutian
E. O. Chekanova
M. N. Zakharova
author_facet M. Yu. Maximova
E. A. Golovneva
A. G. Broutian
E. O. Chekanova
M. N. Zakharova
author_sort M. Yu. Maximova
collection DOAJ
description Background. Epileptic seizures are involved in the diagnostic criteria for autoimmune encephalitis (AE). In this regard, timing of onset of focal-to-bilateral tonic-clonic seizure (BTCS) transition and status epilepticus (SE) in AE is understudied.Objective: to compare the timing of onset for focal-to-BTCS and SE during AE.Material and methods. Examination of patients with AE included collecting patient history, conducting blood and cerebrospinal fluid tests, magnetic resonance imaging, and long-term electroencephalographic video-monitoring. Out of 41 examined patients, 22 (54%) were diagnosed with “suspected AE” and 19 (46%) patients had “verified AE”. Focal-to-BTCS were noted in patient history of 36 (88%) subjects, including subsequent SE observed in 12 (29%) cases.Results. A single focal-to-BTCS/SE was the first AE symptom found in 8 (22%) patients, including 1 patient bearing antibodies against glutamate decarboxylase 65 (GAD65). In 8 (22%) cases, AE manifested with focal seizures, whereas focal-to-BTCS and/or SE developed later. This type of AE course was most commonly observed in patients with anti-GAD65 antibody-positive encephalitis (4 out of 9 cases). Focal-to-BTCS and SE developed only at disease onset and during exacerbations of the immune process in 5 (14%) patients, 2 of whom carried anti-myelin oligodendrocyte glycoprotein antibodies.Conclusion. Focal-to-BTCS and SE most often emerge at AE onset. Anti-GAD65 antibody-positive encephalitis is manifested by long-lasting drug-resistant epilepsy with late onset of focal-to-BTCS and SE. In case of anti-GAD65 antibody-positive AE, epileptic seizures occur only at disease onset.
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spelling doaj-art-8828d89d82f64383ba1d75e403154cd52025-08-20T02:54:05ZrusIRBIS LLCЭпилепсия и пароксизмальные состояния2077-83332311-40882025-05-01171404710.17749/2077-8333/epi.par.con.2025.215673Bilateral tonic-clonic seizures and status epilepticus in autoimmune encephalitisM. Yu. Maximova0E. A. Golovneva1A. G. Broutian2E. O. Chekanova3M. N. Zakharova4Research Center of NeurologyResearch Center of NeurologyResearch Center of NeurologyResearch Center of NeurologyResearch Center of NeurologyBackground. Epileptic seizures are involved in the diagnostic criteria for autoimmune encephalitis (AE). In this regard, timing of onset of focal-to-bilateral tonic-clonic seizure (BTCS) transition and status epilepticus (SE) in AE is understudied.Objective: to compare the timing of onset for focal-to-BTCS and SE during AE.Material and methods. Examination of patients with AE included collecting patient history, conducting blood and cerebrospinal fluid tests, magnetic resonance imaging, and long-term electroencephalographic video-monitoring. Out of 41 examined patients, 22 (54%) were diagnosed with “suspected AE” and 19 (46%) patients had “verified AE”. Focal-to-BTCS were noted in patient history of 36 (88%) subjects, including subsequent SE observed in 12 (29%) cases.Results. A single focal-to-BTCS/SE was the first AE symptom found in 8 (22%) patients, including 1 patient bearing antibodies against glutamate decarboxylase 65 (GAD65). In 8 (22%) cases, AE manifested with focal seizures, whereas focal-to-BTCS and/or SE developed later. This type of AE course was most commonly observed in patients with anti-GAD65 antibody-positive encephalitis (4 out of 9 cases). Focal-to-BTCS and SE developed only at disease onset and during exacerbations of the immune process in 5 (14%) patients, 2 of whom carried anti-myelin oligodendrocyte glycoprotein antibodies.Conclusion. Focal-to-BTCS and SE most often emerge at AE onset. Anti-GAD65 antibody-positive encephalitis is manifested by long-lasting drug-resistant epilepsy with late onset of focal-to-BTCS and SE. In case of anti-GAD65 antibody-positive AE, epileptic seizures occur only at disease onset.https://www.epilepsia.su/jour/article/view/1186epilepsyautoimmune encephalitisbilateral tonic-clonic seizuresstatus epilepticusautoimmune encephalitis with seizureselectroencephalography
spellingShingle M. Yu. Maximova
E. A. Golovneva
A. G. Broutian
E. O. Chekanova
M. N. Zakharova
Bilateral tonic-clonic seizures and status epilepticus in autoimmune encephalitis
Эпилепсия и пароксизмальные состояния
epilepsy
autoimmune encephalitis
bilateral tonic-clonic seizures
status epilepticus
autoimmune encephalitis with seizures
electroencephalography
title Bilateral tonic-clonic seizures and status epilepticus in autoimmune encephalitis
title_full Bilateral tonic-clonic seizures and status epilepticus in autoimmune encephalitis
title_fullStr Bilateral tonic-clonic seizures and status epilepticus in autoimmune encephalitis
title_full_unstemmed Bilateral tonic-clonic seizures and status epilepticus in autoimmune encephalitis
title_short Bilateral tonic-clonic seizures and status epilepticus in autoimmune encephalitis
title_sort bilateral tonic clonic seizures and status epilepticus in autoimmune encephalitis
topic epilepsy
autoimmune encephalitis
bilateral tonic-clonic seizures
status epilepticus
autoimmune encephalitis with seizures
electroencephalography
url https://www.epilepsia.su/jour/article/view/1186
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AT eagolovneva bilateraltonicclonicseizuresandstatusepilepticusinautoimmuneencephalitis
AT agbroutian bilateraltonicclonicseizuresandstatusepilepticusinautoimmuneencephalitis
AT eochekanova bilateraltonicclonicseizuresandstatusepilepticusinautoimmuneencephalitis
AT mnzakharova bilateraltonicclonicseizuresandstatusepilepticusinautoimmuneencephalitis