Use of anti-seizure medications in different types of autoimmune encephalitis: A narrative review
Seizures are the main manifestation of the acute phase of autoimmune encephalitis (AE). Anti-seizure medications (ASMs) play an important role in controlling seizures in AE patients, but there is currently a lack of consensus regarding the selection, application, and discontinuation of ASMs. This na...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-03-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2023.1111384/full |
| _version_ | 1797862055761412096 |
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| author | Jinyuan Du Yi Guo Yi Guo Qiong Zhu Qiong Zhu |
| author_facet | Jinyuan Du Yi Guo Yi Guo Qiong Zhu Qiong Zhu |
| author_sort | Jinyuan Du |
| collection | DOAJ |
| description | Seizures are the main manifestation of the acute phase of autoimmune encephalitis (AE). Anti-seizure medications (ASMs) play an important role in controlling seizures in AE patients, but there is currently a lack of consensus regarding the selection, application, and discontinuation of ASMs. This narrative review focuses on the use of ASMs in patients with AE driven by different antibodies. The PubMed, Embase, and MEDLINE databases were searched up until 30 October 2022 using prespecified search terms. We identified 2,580 studies; 23 retrospective studies, 2 prospective studies and 9 case reports were evaluated based on our inclusion criteria. Anti-N-methyl-D-aspartic-acid-receptor (anti-NMDAR) encephalitis is the type of AE that responds best to ASMs, and long-term or combined use of ASMs may be not required in most patients with seizures; these results apply to both adults and children. Sodium channel blockers may be the best option for seizures in anti-leucine-rich-glioma-inactivated-1 (anti-LGI1) encephalitis, but patients with anti-LGI1 encephalitis are prone to side effects when using ASMs. Cell surface antibody-mediated AE patients are more likely to use ASMs for a long period than patients with intracellular antibody-mediated AE. Clinicians can score AE patients’ clinical characteristics on a scale to identify those who may require long-or short-term use of ASMs in the early stage. This review provides some recommendations for the rational use of ASMs in encephalitis mediated by different antibodies with the aim of controlling seizures and avoiding overtreatment. |
| first_indexed | 2024-04-09T22:13:06Z |
| format | Article |
| id | doaj.art-abd34abcfe49412286ce367dc635bb5e |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-09T22:13:06Z |
| publishDate | 2023-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-abd34abcfe49412286ce367dc635bb5e2023-03-23T06:49:18ZengFrontiers Media S.A.Frontiers in Neurology1664-22952023-03-011410.3389/fneur.2023.11113841111384Use of anti-seizure medications in different types of autoimmune encephalitis: A narrative reviewJinyuan Du0Yi Guo1Yi Guo2Qiong Zhu3Qiong Zhu4Department of Neurology, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, ChinaDepartment of Neurology, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, ChinaChinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, ChinaDepartment of Neurology, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, ChinaChinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, ChinaSeizures are the main manifestation of the acute phase of autoimmune encephalitis (AE). Anti-seizure medications (ASMs) play an important role in controlling seizures in AE patients, but there is currently a lack of consensus regarding the selection, application, and discontinuation of ASMs. This narrative review focuses on the use of ASMs in patients with AE driven by different antibodies. The PubMed, Embase, and MEDLINE databases were searched up until 30 October 2022 using prespecified search terms. We identified 2,580 studies; 23 retrospective studies, 2 prospective studies and 9 case reports were evaluated based on our inclusion criteria. Anti-N-methyl-D-aspartic-acid-receptor (anti-NMDAR) encephalitis is the type of AE that responds best to ASMs, and long-term or combined use of ASMs may be not required in most patients with seizures; these results apply to both adults and children. Sodium channel blockers may be the best option for seizures in anti-leucine-rich-glioma-inactivated-1 (anti-LGI1) encephalitis, but patients with anti-LGI1 encephalitis are prone to side effects when using ASMs. Cell surface antibody-mediated AE patients are more likely to use ASMs for a long period than patients with intracellular antibody-mediated AE. Clinicians can score AE patients’ clinical characteristics on a scale to identify those who may require long-or short-term use of ASMs in the early stage. This review provides some recommendations for the rational use of ASMs in encephalitis mediated by different antibodies with the aim of controlling seizures and avoiding overtreatment.https://www.frontiersin.org/articles/10.3389/fneur.2023.1111384/fullautoimmune encephalitisanti-seizure medicationsseizureantibodiesanti-NMDAR encephalitisanti-LGI1 encephalitis |
| spellingShingle | Jinyuan Du Yi Guo Yi Guo Qiong Zhu Qiong Zhu Use of anti-seizure medications in different types of autoimmune encephalitis: A narrative review Frontiers in Neurology autoimmune encephalitis anti-seizure medications seizure antibodies anti-NMDAR encephalitis anti-LGI1 encephalitis |
| title | Use of anti-seizure medications in different types of autoimmune encephalitis: A narrative review |
| title_full | Use of anti-seizure medications in different types of autoimmune encephalitis: A narrative review |
| title_fullStr | Use of anti-seizure medications in different types of autoimmune encephalitis: A narrative review |
| title_full_unstemmed | Use of anti-seizure medications in different types of autoimmune encephalitis: A narrative review |
| title_short | Use of anti-seizure medications in different types of autoimmune encephalitis: A narrative review |
| title_sort | use of anti seizure medications in different types of autoimmune encephalitis a narrative review |
| topic | autoimmune encephalitis anti-seizure medications seizure antibodies anti-NMDAR encephalitis anti-LGI1 encephalitis |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2023.1111384/full |
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