Research Article

Seizures as Initial Presentation and Enduring Predisposition to Seizures in Autoimmune Encephalitis

Table 1

The comparison of demographics and clinical characteristics between the onset with seizures group and the onset with nonseizures group in AE patients.

VariablesOnset with seizures (148, 44.1%)Onset with nonseizures (195, 56.9%) value

Age at onset, Y, median [IQR]28 [19-43.5]46 [27-58]<0.001
Sex: male, (%)70 (47.3%)95 (48.7%)0.794
Antineuronal antibodies findings
 Antibody positive, (%)90 (60.8%)108 (55.4%)0.314
  NMDAR59 (65.6%)60 (55%)0.108
  LGI14 (4.4%)10 (9.3%)0.471
  GABABR16 (18%)3 (3%)<0.001
  CASPR21 (1%)10 (9%)0.014
  AMPA05 (5%)0.041
  DPPX2 (2.2%)9 (8.3%)0.014
  Multiantibodies5 (6%)4 (4%)0.513
 Antibodies against cell surface antigens, (%)89 (98.9%)105 (97.2%)0.407
 Antibody negative, (%)58 (39.2%)87 (44.6%)0.398
 Antibody titres, (%)
  +19 (21.1%)31 (28.7%)0.221
  ++37 (41.1%)50 (46.3%)0.464
  +++34 (37.8%)27 (25.0%)0.052
Seizure type at onset
 Generalized, (%)24 (16.2%)
 Focal motor, (%)50 (33.8%)
 Focal nonmotor, (%)14 (9.5%)
 Focal to bilateral, (%)100 (67.6%)
 Multiple seizure type, (%)40 (27.0%)
 FBDS, (%)3 (2.0%)
Seizure frequency at onset
 Daily, (%)79 (53.4%)
 Weekly, (%)30 (20.3%)
 Monthly, (%)39 (26.6%)
Drug resistance to ASMs during the acute phase, (%)43 (29.1%)
Encephalitis-associated symptoms
 Prodromal symptoms, (%)79 (53.4%)120 (61.5%)0.129
 Altered level of consciousness, (%)46 (31.1%)68 (34.9%)0.460
 Behavior disorders, (%)61 (41.2%)120 (62.5%)<0.001
 Short-term memory deficits, (%)26 (17.6%)60 (30.8%)0.005
 Cognitive disorders, (%)45 (30.4%)89 (45.6%)0.004
 Speech disorders, (%)12 (8.1%)41 (21.0%)0.001
 Sleep disorders, (%)13 (8.8%)22 (11.3%)0.449
 Autonomic dysfunction, (%)5 (3.4%)12 (6.2%)0.241
 Central hypoventilation, (%)7 (4.7%)3 (1.5%)0.082
 Admission in ICU, (%)53 (35.8%)54 (27.7%)0.108
 Lung infection, (%)47 (31.8%)50 (25.6%)0.213
 Confirmed tumors, (%)5 (3.4%)20 (10.3%)0.015
CSF routine examination
 CSF WBC count 1060.856
 CSF protein level (mg/L)<0.001
 CSF immunoglobulin G level (g/L)<0.001
 CSF immunoglobulin M level (g/L)0.098
 CSF immunoglobulin A level (g/L)0.001
Abnormal EEG findings, (%)83 (56.1%)60 (31.3%)<0.001
 Diffuse/focal slow activity, (%)52 (35.1%)44 (22.9%)0.013
 Diffuse IEDs, (%)21 (14.2%)13 (6.8%)0.024
 Temporal IEDs, (%)6 (4.1%)3 (1.6%)0.156
 Extratemporal IEDs, (%)4 (2.7%)00.022
Abnormal MRI findings, (%)81(54.7%)114 (58.5%)0.489
 T-plus, (%)62 (41.9%)87 (44.6%)0.614
 Extra-T, (%)19 (12.8%)27 (13.8%)0.786
 Both, (%)35 (23.6%)61 (31.3%)0.119
MRS scores at onset, median [IQR]2 [1-3]2 [1-3]0.549
MRS scores at discharge, median [IQR]1 [0-3]1 [1-3]0.017

In addition, there were also 1 anti-GAD65 encephalitis, 2 anti-mGLUR5 encephalitis, 4 anti-MOG encephalitis, 1 anti-Ri encephalitis, 1 anti-Yo encephalitis, and 1 anti-SOX1 encephalitis. Abbreviations: FBDS: faciobrachial dystonic seizures; ASMs: antiseizure medications (ASMs); MRS: modified Rankin Scale; IEDs: interictal epileptiform discharges; T: temporal.