Autoimmune-associated seizures and epilepsy are increasingly recognized in clinical practice and can arise in the setting of acute encephalitis but in some cases may present with chronic focal epilepsy. These conditions are usually resistant to antiseizure therapy but may respond definitively to timely immunotherapy. Early diagnosis and treatment are critical to minimize neural injury and optimize outcomes.Treatment is guided by consensus opinion because definitive trials are currently lacking. The initial management approach usually involves first-line agents such as corticosteroids, intravenous immunoglobulin (IVIg), or plasma exchange, with second-line agents like rituximab or cyclophosphamide. Maintenance therapy is considered to prevent relapses, which occur in up to 35% of patients. Relapse management requires careful differentiation from postencephalitic epilepsy, which in the absence of active inflammation does not respond to immunotherapy.This review discusses treatment strategies for autoimmune-associated seizure disorders, including acute symptomatic seizures and epilepsy. We discuss expected outcomes on the basis of the underlying pathogenesis including cases mediated by autoantibodies targeting specific neuronal surface/synaptic antigens, and intracellular epitopes, and for cases lacking defined biomarkers. Specific approaches are outlined for disorders such as anti-LGI1, anti-NMDAR, anti-GABA-BR, and anti-GAD65 encephalitides, emphasizing tailored immunotherapy based on pathophysiology and clinical context.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1055/a-2525-3511 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Seizures Associated with Autoimmune Disorders - Current Treatment Approaches.
Semin Neurol
March 2025
Epilepsy Division, Department of Neurology, Mayo Clinic, Rochester, Minnesota.
Autoimmune-associated seizures and epilepsy are increasingly recognized in clinical practice and can arise in the setting of acute encephalitis but in some cases may present with chronic focal epilepsy. These conditions are usually resistant to antiseizure therapy but may respond definitively to timely immunotherapy. Early diagnosis and treatment are critical to minimize neural injury and optimize outcomes.
View Article and Find Full Text PDFReal-world experience of cannabidiol in conjunction with clobazam for the treatment of seizures associated with Lennox-Gastaut syndrome and Dravet syndrome: Results from a retrospective multicentre chart review in Germany.
Epilepsy Behav
March 2025
Goethe-University Frankfurt, Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, University Hospital Frankfurt, Frankfurt am Main, Germany.
Background: Lennox-Gastaut syndrome (LGS) and Dravet syndrome (DS) are rare and debilitating forms of epilepsy, characterised by recurrent, severe, drug-resistant seizures and neurodevelopmental impairments. A non-euphoric, plant-derived, highly purified formulation of cannabidiol (CBD; Epidyolex®, 100 mg/mL oral solution) is approved in the European Union and United Kingdom for use in patients aged ≥2 years for the adjunctive treatment of seizures associated with LGS or DS in conjunction with clobazam (CLB), and for the adjunctive treatment of seizures associated with tuberous sclerosis complex in patients aged ≥2 years.
Methods: We performed a retrospective chart review of patients with treatment-resistant epilepsies who were treated with adjunctive CBD at six epilepsy centres in Germany.
Seizures, Driver Licensure, and Medical Reporting Update: An AAN Position Statement.
Neurology
April 2025
School of Law, University of Virginia, Charlottesville.
This consensus position statement of the American Academy of Neurology, American Epilepsy Society, and Epilepsy Foundation of America updates prior 1994 and 2007 position statements on seizures, driver licensure, and medical reporting. Key consensus positions include the following: (1) in the United States, national driving standards promulgated through a system such as the Uniform Law Commission would reduce confusion and improve adherence with state driving standards; (2) state licensing criteria for medical conditions should be promulgated by regulations and guidelines based on enabling legislation rather than in statutes themselves and should be developed by medical advisory boards working in collaboration with departments of motor vehicles; (3) licensing criteria should be equitable, nondiscriminatory, objective, and compatible with comparable risks in other populations; (4) a minimum seizure-free interval of 3 months should ordinarily be required before driving in all cases and should be extended in individual cases based on review of favorable and unfavorable features by medical advisory boards; (5) individuals with exclusively provoked seizures attributable to provoking factors that are unlikely to reoccur in the future may not require a seizure-free interval before resuming driving; (6) individuals with previously well-controlled epilepsy who experience seizures due to short-term interruptions of antiseizure medications in the setting of hospitalization or practitioner-directed medication-titration may not require a seizure-free interval before driving once previously effective levels of antiseizure medications have been resumed; (7) patients and practitioners should pause driving during tapering and following discontinuation of an antiseizure medication if another such medication is not introduced; (8) individuals whose cognition or coordination is impaired due to medications used to prevent seizures should refrain from driving; (9) health care practitioners should be allowed but not mandated to report drivers who pose an elevated risk; but (10) neither a decision to report a patient suspected of being at elevated risk nor a decision declining to report a patient suspected of being at elevated risk should be subject to legal liability; (11) nations, states, and municipalities should provide alternative methods of transportation and accommodations for individuals whose driving privileges are restricted due to medical conditions.
View Article and Find Full Text PDFSemiology of seizures with temporo-polar or "medio-lateral" temporal origin: A systematic review.
Epileptic Disord
March 2025
Freiburg Epilepsy Center, Member of the ERN EpiCARE, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
A systematic review using PRISMA criteria was used to review the literature regarding the specific semiology of seizure arising (a) from the temporal pole or (b) from both medial and lateral temporal cortex. Evidence was analyzed with regard to information provided by intracranial EEG recordings and surgical outcomes, and an estimation of validity of reported signs and symptoms was performed. Semiology of seizures originating from the temporal pole was mostly related to diverse patterns of ictal spread rather than to the localization of seizure origin and comprised a wide variety of early signs and symptoms.
View Article and Find Full Text PDFTetrapleura tetraptera fruit extracts ameliorate pentylenetetrazol-induced seizures as well as ensuing cognitive deficit and oxidative stress.
Metab Brain Dis
March 2025
Department of Biochemistry, Faculty of Sciences, University of Uyo, Uyo, Nigeria.
Kindling is an experimental-induced seizure consistent with epilepsy disease, a chronic neurological disorder characterised by spontaneous and repeated seizures. This disease is associated with oxidative stress, and most therapeutic strategies against epilepsy aim at improving the antioxidant defence mechanism in the brain. However, prolonged usage and associated adverse side effects limit antiepileptics, warranting natural antioxidant patronage.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!