The value of immunotherapy in children with initial short-term frequent seizures
This study aimed to discuss clinical characteristics, therapy, and antibody prevalence in epilepsy (APE) score for short-term, frequent epileptic seizures in children who are autoimmune-antibody negative and respond well to immunotherapy. The clinical characteristics, imaging manifestations, electro...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-09-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2022.948727/full |
| _version_ | 1811277416327282688 |
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| author | Yongheng Zhao Yongheng Zhao Jun Li Liang Gao Liang Gao Xiaofan Yang Haiqing Zhao Haiqing Zhao Yumei Li Yumei Li Li Su Li Su Xiaoyu Zhao Xiaoyu Zhao Hao Ding Hao Ding Baomin Li |
| author_facet | Yongheng Zhao Yongheng Zhao Jun Li Liang Gao Liang Gao Xiaofan Yang Haiqing Zhao Haiqing Zhao Yumei Li Yumei Li Li Su Li Su Xiaoyu Zhao Xiaoyu Zhao Hao Ding Hao Ding Baomin Li |
| author_sort | Yongheng Zhao |
| collection | DOAJ |
| description | This study aimed to discuss clinical characteristics, therapy, and antibody prevalence in epilepsy (APE) score for short-term, frequent epileptic seizures in children who are autoimmune-antibody negative and respond well to immunotherapy. The clinical characteristics, imaging manifestations, electrophysiology, and effective treatment plan of 9 children who met the above criteria were retrospectively analyzed in the Pediatric Neurology Department of Qilu Hospital at Shandong University from June 2019 to December 2021. All 9 patients (6 boys, 3 girls; aged 13 months−11 years and 5 months, median 3.5 years) had acute-onset seizures within 3 months. All had previous normal growth/development with no family history of disease. Seizure types were focal motor seizures (6), generalized tonic-clonic seizures (2), and generalized secondary-to-focal (1); occurred >10 times/day; and lasted <1 min/episode. Formal treatment with ≥2 types of antiseizure medicine (ASM) achieved an unsatisfactory effect. Cranial magnetic resonance imaging showed an abnormal result in 1 case. The APE score was ≥4 in 3 cases and <4 in 6 cases. All patients experienced symptomatic relief with immunotherapy; subsequently, 8 patients were free of recurrence and 1 had significantly reduced seizure frequency. Autoimmune antibody screening is recommended for children who were previously well and have acute-onset epilepsy; high frequency, short-duration seizures; no good response to 2 types of ASM; and other etiologic factors excluded, even with APE score <4. Even with negative autoimmune antibody results, the possibility of autoimmune epilepsy should be considered for urgent initiation of immunotherapy, which can achieve good results. |
| first_indexed | 2024-04-13T00:15:17Z |
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| id | doaj.art-f3802e9aad3a49c3ace581e2c7538aef |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-13T00:15:17Z |
| publishDate | 2022-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-f3802e9aad3a49c3ace581e2c7538aef2022-12-22T03:10:57ZengFrontiers Media S.A.Frontiers in Neurology1664-22952022-09-011310.3389/fneur.2022.948727948727The value of immunotherapy in children with initial short-term frequent seizuresYongheng Zhao0Yongheng Zhao1Jun Li2Liang Gao3Liang Gao4Xiaofan Yang5Haiqing Zhao6Haiqing Zhao7Yumei Li8Yumei Li9Li Su10Li Su11Xiaoyu Zhao12Xiaoyu Zhao13Hao Ding14Hao Ding15Baomin Li16Department of Pediatrics, Qilu Hospital of Shandong University, Jinan, ChinaCheeloo College of Medicine, Shandong University, Jinan, ChinaDepartment of Pediatrics, Qilu Hospital of Shandong University, Jinan, ChinaDepartment of Pediatrics, Qilu Hospital of Shandong University, Jinan, ChinaCheeloo College of Medicine, Shandong University, Jinan, ChinaDepartment of Pediatrics, Qilu Hospital of Shandong University, Jinan, ChinaDepartment of Pediatrics, Qilu Hospital of Shandong University, Jinan, ChinaCheeloo College of Medicine, Shandong University, Jinan, ChinaDepartment of Pediatrics, Qilu Hospital of Shandong University, Jinan, ChinaCheeloo College of Medicine, Shandong University, Jinan, ChinaDepartment of Pediatrics, Qilu Hospital of Shandong University, Jinan, ChinaCheeloo College of Medicine, Shandong University, Jinan, ChinaDepartment of Pediatrics, Qilu Hospital of Shandong University, Jinan, ChinaCheeloo College of Medicine, Shandong University, Jinan, ChinaDepartment of Pediatrics, Qilu Hospital of Shandong University, Jinan, ChinaCheeloo College of Medicine, Shandong University, Jinan, ChinaDepartment of Pediatrics, Qilu Hospital of Shandong University, Jinan, ChinaThis study aimed to discuss clinical characteristics, therapy, and antibody prevalence in epilepsy (APE) score for short-term, frequent epileptic seizures in children who are autoimmune-antibody negative and respond well to immunotherapy. The clinical characteristics, imaging manifestations, electrophysiology, and effective treatment plan of 9 children who met the above criteria were retrospectively analyzed in the Pediatric Neurology Department of Qilu Hospital at Shandong University from June 2019 to December 2021. All 9 patients (6 boys, 3 girls; aged 13 months−11 years and 5 months, median 3.5 years) had acute-onset seizures within 3 months. All had previous normal growth/development with no family history of disease. Seizure types were focal motor seizures (6), generalized tonic-clonic seizures (2), and generalized secondary-to-focal (1); occurred >10 times/day; and lasted <1 min/episode. Formal treatment with ≥2 types of antiseizure medicine (ASM) achieved an unsatisfactory effect. Cranial magnetic resonance imaging showed an abnormal result in 1 case. The APE score was ≥4 in 3 cases and <4 in 6 cases. All patients experienced symptomatic relief with immunotherapy; subsequently, 8 patients were free of recurrence and 1 had significantly reduced seizure frequency. Autoimmune antibody screening is recommended for children who were previously well and have acute-onset epilepsy; high frequency, short-duration seizures; no good response to 2 types of ASM; and other etiologic factors excluded, even with APE score <4. Even with negative autoimmune antibody results, the possibility of autoimmune epilepsy should be considered for urgent initiation of immunotherapy, which can achieve good results.https://www.frontiersin.org/articles/10.3389/fneur.2022.948727/fullautoimmune epilepsyautoimmune antibody negativityimmunotherapy for epilepsyantibody prevalence in epilepsy (APE) scoreautoimmune encephalitis |
| spellingShingle | Yongheng Zhao Yongheng Zhao Jun Li Liang Gao Liang Gao Xiaofan Yang Haiqing Zhao Haiqing Zhao Yumei Li Yumei Li Li Su Li Su Xiaoyu Zhao Xiaoyu Zhao Hao Ding Hao Ding Baomin Li The value of immunotherapy in children with initial short-term frequent seizures Frontiers in Neurology autoimmune epilepsy autoimmune antibody negativity immunotherapy for epilepsy antibody prevalence in epilepsy (APE) score autoimmune encephalitis |
| title | The value of immunotherapy in children with initial short-term frequent seizures |
| title_full | The value of immunotherapy in children with initial short-term frequent seizures |
| title_fullStr | The value of immunotherapy in children with initial short-term frequent seizures |
| title_full_unstemmed | The value of immunotherapy in children with initial short-term frequent seizures |
| title_short | The value of immunotherapy in children with initial short-term frequent seizures |
| title_sort | value of immunotherapy in children with initial short term frequent seizures |
| topic | autoimmune epilepsy autoimmune antibody negativity immunotherapy for epilepsy antibody prevalence in epilepsy (APE) score autoimmune encephalitis |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2022.948727/full |
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