Authors :
Annie Hong, Cohen Children's Hospital, Northwell Health System; Yash Shah - Cohen Children's Hospital, Northwell Health System; Ann Morse - Geisinger Commonwealth School of Medicine; Jacob Pickle - Geisinger Commonwealth School of Medicine; Rebecca Lynch
Rationale:
Autoimmune encephalitis is an increasingly recognized class of inflammatory diseases of the brain that can present with seizures. The purpose of this study was to compare seizure type and EEG findings in pediatric versus adult patients diagnosed with autoimmune encephalitis
Method:
This was a retrospective review of clinical and EEG data from pediatric and adult patients with a diagnosis of autoimmune encephalitis from three medical centers. Patients with positive CSF autoantibody results and autoantibody-negative but probable autoimmune encephalitis were included utilizing criteria from a recent position paper on a clinical approach to the diagnosis of autoimmune encephalitis (Lancet Neurology 2016).
Results:
There was a total of 102 patients, of whom 67 were pediatric (65.7%). Seizures were a presenting symptom in 46 (45%) patients. Status epilepticus was present in 15% of patients. EEG findings including diffuse slowing (46%), focal spikes (22.5%), focal slowing (12.7%), or delta brush (1%). EEG was normal in 12% of cases. Pediatric patients had a higher incidence of focal seizures and status epilepticus compared to adult patients (p< 0.05). Patients with positive CSF anti-neuronal antibody results were more likely to have seizures and focal slowing on EEG, compared to autoantibody-negative patients (p=0.04). (Table 1)
Conclusion:
Autoimmune encephalitis is more likely to present with focal seizures and status epilepticus in children. Autoantibody status is associated with seizures and focal slowing on EEG. Further study can be performed to explore the incidence of chronic epilepsy in this subset of patients.
Funding:
:None
FIGURES
Figure 1