Prevalence of neurologic autoantibodies in cohorts of patients with new and established epilepsy.
PURPOSE: Autoantibodies to specific neurologic proteins are associated with subacute onset encephalopathies, which often present with seizures that are poorly controlled by conventional antiepileptic drugs (AEDs). Previous cross-sectional studies have found specific neurologic antibodies in a small...
| Egile Nagusiak: | , , , , , , , |
|---|---|
| Formatua: | Journal article |
| Hizkuntza: | English |
| Argitaratua: |
John Wiley and Sons, inc.
2013
|
| _version_ | 1826297057585922048 |
|---|---|
| author | Brenner, T Sills, G Hart, Y Howell, S Waters, P Brodie, M Vincent, A Lang, B |
| author_facet | Brenner, T Sills, G Hart, Y Howell, S Waters, P Brodie, M Vincent, A Lang, B |
| author_sort | Brenner, T |
| collection | OXFORD |
| description | PURPOSE: Autoantibodies to specific neurologic proteins are associated with subacute onset encephalopathies, which often present with seizures that are poorly controlled by conventional antiepileptic drugs (AEDs). Previous cross-sectional studies have found specific neurologic antibodies in a small proportion of people with established epilepsy, but these investigations have seldom included patients with recent diagnosis. METHODS: We screened two large epilepsy cohorts to investigate the prevalence of multiple autoantibodies in adult patients with either established or newly diagnosed, untreated epilepsy. KEY FINDINGS: Eleven percent of patients had antibodies to one or more antigen: voltage-gated potassium channel (VGKC) complex proteins (5%), glycine receptors (3%), and glutamic acid decarboxylase (GAD) and N-methyl-D-aspartate (NMDA) receptors (1.7% each). There was no difference in the prevalence of antibodies, individually or collectively, between patients with established and newly diagnosed epilepsy or with generalized or focal epilepsy. There was, however, a significantly higher prevalence of positive antibody titers in patients with focal epilepsy of unknown cause than in those with structural/metabolic focal epilepsy (14.8% vs. 6.3%; p < 0.02). Newly diagnosed antibody-positive patients were less likely to achieve adequate seizure control with initial treatment than antibody-negative patients, but this difference failed to reach statistical significance. SIGNIFICANCE: The presence of autoantibodies is equally common in newly diagnosed and established epilepsy, it is therefore unlikely to be an epiphenomenon of long-standing refractory seizures. |
| first_indexed | 2024-03-07T04:25:49Z |
| format | Journal article |
| id | oxford-uuid:cc94d47f-723a-492d-a57b-1bba3bfd280b |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T04:25:49Z |
| publishDate | 2013 |
| publisher | John Wiley and Sons, inc. |
| record_format | dspace |
| spelling | oxford-uuid:cc94d47f-723a-492d-a57b-1bba3bfd280b2022-03-27T07:22:56ZPrevalence of neurologic autoantibodies in cohorts of patients with new and established epilepsy.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:cc94d47f-723a-492d-a57b-1bba3bfd280bEnglishSymplectic Elements at OxfordJohn Wiley and Sons, inc.2013Brenner, TSills, GHart, YHowell, SWaters, PBrodie, MVincent, ALang, BPURPOSE: Autoantibodies to specific neurologic proteins are associated with subacute onset encephalopathies, which often present with seizures that are poorly controlled by conventional antiepileptic drugs (AEDs). Previous cross-sectional studies have found specific neurologic antibodies in a small proportion of people with established epilepsy, but these investigations have seldom included patients with recent diagnosis. METHODS: We screened two large epilepsy cohorts to investigate the prevalence of multiple autoantibodies in adult patients with either established or newly diagnosed, untreated epilepsy. KEY FINDINGS: Eleven percent of patients had antibodies to one or more antigen: voltage-gated potassium channel (VGKC) complex proteins (5%), glycine receptors (3%), and glutamic acid decarboxylase (GAD) and N-methyl-D-aspartate (NMDA) receptors (1.7% each). There was no difference in the prevalence of antibodies, individually or collectively, between patients with established and newly diagnosed epilepsy or with generalized or focal epilepsy. There was, however, a significantly higher prevalence of positive antibody titers in patients with focal epilepsy of unknown cause than in those with structural/metabolic focal epilepsy (14.8% vs. 6.3%; p < 0.02). Newly diagnosed antibody-positive patients were less likely to achieve adequate seizure control with initial treatment than antibody-negative patients, but this difference failed to reach statistical significance. SIGNIFICANCE: The presence of autoantibodies is equally common in newly diagnosed and established epilepsy, it is therefore unlikely to be an epiphenomenon of long-standing refractory seizures. |
| spellingShingle | Brenner, T Sills, G Hart, Y Howell, S Waters, P Brodie, M Vincent, A Lang, B Prevalence of neurologic autoantibodies in cohorts of patients with new and established epilepsy. |
| title | Prevalence of neurologic autoantibodies in cohorts of patients with new and established epilepsy. |
| title_full | Prevalence of neurologic autoantibodies in cohorts of patients with new and established epilepsy. |
| title_fullStr | Prevalence of neurologic autoantibodies in cohorts of patients with new and established epilepsy. |
| title_full_unstemmed | Prevalence of neurologic autoantibodies in cohorts of patients with new and established epilepsy. |
| title_short | Prevalence of neurologic autoantibodies in cohorts of patients with new and established epilepsy. |
| title_sort | prevalence of neurologic autoantibodies in cohorts of patients with new and established epilepsy |
| work_keys_str_mv | AT brennert prevalenceofneurologicautoantibodiesincohortsofpatientswithnewandestablishedepilepsy AT sillsg prevalenceofneurologicautoantibodiesincohortsofpatientswithnewandestablishedepilepsy AT harty prevalenceofneurologicautoantibodiesincohortsofpatientswithnewandestablishedepilepsy AT howells prevalenceofneurologicautoantibodiesincohortsofpatientswithnewandestablishedepilepsy AT watersp prevalenceofneurologicautoantibodiesincohortsofpatientswithnewandestablishedepilepsy AT brodiem prevalenceofneurologicautoantibodiesincohortsofpatientswithnewandestablishedepilepsy AT vincenta prevalenceofneurologicautoantibodiesincohortsofpatientswithnewandestablishedepilepsy AT langb prevalenceofneurologicautoantibodiesincohortsofpatientswithnewandestablishedepilepsy |