Antibody-mediated status epilepticus: a retrospective multicenter survey.

Details

Serval ID
serval:BIB_1300ED683E0E
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Antibody-mediated status epilepticus: a retrospective multicenter survey.
Journal
European Neurology
Author(s)
Holzer F.J., Rossetti A.O., Heritier-Barras A.C., Zumsteg D., Roebling R., Huber R., Lerche H., Kiphuth I.C., Bardutzky J., Bien C.G., Tröger M., Schoch G., Prüss H., Seeck M.
ISSN
1421-9913 (Electronic)
ISSN-L
0014-3022
Publication state
Published
Issued date
2012
Peer-reviewed
Oui
Volume
68
Number
5
Pages
310-317
Language
english
Notes
Publication types: Journal Article WOS Document Type: Article
Abstract
Background: In recent years, an increasing number of auto-antibodies (AB) have been detected in the CSF and serum of patients with new onset epilepsy. Some of these patients develop convulsive or nonconvulsive status epilepticus (AB-SE), necessitating intensive medical care and administration of multiple antiepileptic and immunomodulatory treatments of uncertain effectiveness. Objectives: In this retrospective multicenter survey we aimed to determine the spectrum of gravity, the duration and the prognosis of the disorder. In addition, we sought to identify the antibodies associated with this condition, as well as determine whether there is a most effective treatment regime. Methods: 12 European Neurology University Clinics, with extensive experience in the treatment of SE patients, were sent a detailed questionnaire regarding symptoms and treatment of AB-SE patients. Seven centers responded positively, providing a total of 13 patients above the age of 16. Results: AB-SE affects mainly women (12/13, 92%) with a variable age at onset (17-69 years, median: 25 years). The duration of the disease is also variable (10 days to 12 years, median: 2 months). Only the 3 oldest patients died (55-69 years). Most patients were diagnosed with anti NMDAR encephalitis (8/13) and had oligoclonal bands in the CSF (9/13). No specific treatment regimen (antiepileptic, immunomodulatory) was found to be clearly superior. Most of the surviving 10 patients (77%) recovered completely or nearly so within 2 years of index poststatus. Conclusion: AB-SE is a severe but potentially reversible condition. Long duration does not seem to imply fatal outcome; however, age older than 50 years at time of onset appears to be a risk factor for death. There was no evidence for an optimal antiepileptic or immunomodulatory treatment. A prospective multicenter study is warranted in order to stratify the optimal treatment algorithm, determine clear risk factors of unfavorable outcome and long-term prognosis.
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Create date
13/12/2012 19:50
Last modification date
20/08/2019 13:41
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