Brenner, T., Sills, G.J., Hart, Y., Howell, S., Waters, P., Brodie, M.J., Vincent, A. and Lang, B. (2013) Prevalence of neurologic autoantibodies in cohorts of patients with new and established epilepsy. Epilepsia, 54(6), pp. 1028-1035. (doi: 10.1111/epi.12127)
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Abstract
<p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p>
Item Type: | Articles |
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Status: | Published |
Refereed: | Yes |
Glasgow Author(s) Enlighten ID: | Brodie, Professor Martin and Sills, Dr Graeme |
Authors: | Brenner, T., Sills, G.J., Hart, Y., Howell, S., Waters, P., Brodie, M.J., Vincent, A., and Lang, B. |
College/School: | College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing |
Journal Name: | Epilepsia |
ISSN: | 0013-9580 |
ISSN (Online): | 1528-1167 |
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