Abstracts

Rationale: The significance of neuronal antibodies (abs) in the development of late-onset epilepsies is still controversial. This study aimed to investigate the frequency and the clinical value of abs to neuronal cell surface in patients with non-lesional late-onset epilepsies.Methods: 62 patients (mean age 74.76 years, ±9.68; range 56-93 years; 36 women) with newly diagnosed late-onset epilepsy (≥55 years of age) and no history of tumor were prospectively studied and followed for at least three months. Only patients with non-lesional brain imaging were considered, except lesions typical for limbic encephalitis. The patient’s sera and cerebral spinal fluid were tested for abs against voltage-gated potassium channels (VGKC), GAD, NMDA-receptors, GABA(B)-receptors, AMPA-receptors, and glycine-receptors.Results: Abs were found in nine patients (14.52%, mean age 71.30 years; ±13,30; range 59-93 years; four women) (Anti-VGKC n=4; anti-NMDA n=1; ANA n=2; Neuropil Abs n=2). Brain imaging (CT and/or MRI) at disease onset was not indicative for limbic encephalitis in any patient, however, temporomesial signal alteraltions corresponding to the EEG focus were found in two patients during the cause. Eight patients were treated with antiepileptic drugs, immunotherapy was performed in three patients. Six patients were seen for follow-up, five of them were seizure-free.Conclusions: Our results suggest that neuronal surface abs may play a role in the pathophysiology of late-onset epilepsies and should be considered in the diagnostic, especially in non-lesional cases.