Early Immunotherapy May Benefit Autoimmune Epilepsy

(HealthDay News) – Patients suspected of having autoimmune epilepsy that fails to respond to anti-epileptic drugs may benefit from early immunotherapy, according to a study published online March 26 in the Archives of Neurology.

Amy M.L. Quek, MBBS, from the Mayo Clinic in Rochester, MN, and colleagues retrospectively identified 32 patients suspected of having autoimmune epilepsy (presence of neural autoantibodies, inflammatory cerebrospinal fluid, or signs of inflammation on magnetic resonance imaging). All of the patients had partial seizures and 81% had failed treatment with at least two anti-epileptic drugs. Immunotherapy was started in 27 patients.

After a median of 17 months, the researchers found that 22 patients (81%) reported improvement after immunotherapy and 18 were free of seizures. Responders had initiated immunotherapy significantly earlier from seizure onset than nonresponders (4 months vs. 22 months). All patients with neural autoantibodies against the voltage-gated potassium channel complex (56% of patients) reported some benefit of immunotherapy.

The study “on autoimmune epilepsy is another reminder that we need to broaden our concept of symptomatic chronic epilepsy from the structural realm into more dynamic processes not limited to acute inflammatory or infectious pathologies (eg, meningitis or encephalitis),” Gregory K. Bergey, MD, from Johns Hopkins Hospital in Baltimore, MD, writes in an accompanying editorial.

Several authors disclosed financial relationships with pharmaceutical and medical device companies. Two authors are named as inventors on patents pertaining to neuromyelitis optica.

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