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000283118 1001_ $$00000-0001-5935-9841$$aBaumgartner, Tobias$$b0
000283118 245__ $$aRisk of Epilepsy and Factors Associated With Time to Seizure Remission in Anti-LGI1 Encephalitis: Long-Term Outcome in 236 Patients.
000283118 260__ $$aPhiladelphia, Pa.$$bWolters Kluwer$$c2025
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000283118 520__ $$aAutoimmune encephalitis (AIE) with anti-leucine-rich glioma-inactivated 1 (LGI1) antibodies typically manifests with subacute cognitive deficits, seizures, and psychiatric symptoms, mostly in older adults. Immunotherapy (IT) leads to the cessation of seizures in most patients, yet some develop AIE-associated epilepsy (AEAE) and persistent cognitive deficits. The aim of this large multicentric retrospective observational cohort study was to assess long-term outcomes of patients with anti-LGI1 encephalitis regarding seizures and AEAE and to identify associated factors.We included patients with anti-LGI1 encephalitis from 3 national referral centers/consortia meeting the following inclusion criteria: (I) definite LGI1 limbic encephalitis (Graus criteria); (II) occurrence of seizures; and (III) follow-up period ≥24 months. We aimed to (1) determine the risk of seizure recurrence (ROSR) on remission, (2) investigate clinical and paraclinical biomarkers for an effect on time to seizure remission using Cox proportional hazard modeling (n = 188), and (3) assess the risk of AEAE and determine associated factors (n = 236).AEAE was observed in 5.9% (16/271) of the full cohort. Both AEAE (16/16 vs 129/215, p = 0.001) and longer time to seizure remission (OR 1.36 per year, p = 0.025) were associated with persistent cognitive impairment. Patients with pilomotor seizures had a lower rate of seizure remission (hazard ratio [HR] 0.58, 95% CI 0.55-0.60, p < 0.001) while patients under IT administration had a higher rate of seizure remission over time (HR 12.4, 95% CI 9.67-16.0, p < 0.001). In addition, patients receiving second-line IT tended to achieve earlier seizure remission (log-rank test, p = 0.019). The ROSR at 12, 60, and 120 months on seizure remission was 9% (95% CI 4.5%-13%), 20% (95% CI 11%-28%), and 53% (95% CI 14%-74%), respectively.In conclusion, our results demonstrate that AEAE in anti-LGI1 encephalitis is rare and suggest that the diagnosis of epilepsy is inappropriate in patients reaching seizure remission because of a relatively low ROSR. Accordingly, on seizure remission, the diagnosis of acute symptomatic seizures would be appropriate. Moreover, we validate and quantify the importance of IT for seizure remission and identify biomarkers associated with lower rates of seizure remission. Late remission of seizures and AEAE were associated with persistent cognitive impairment.
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000283118 650_7 $$2NLM Chemicals$$aAutoantibodies
000283118 650_7 $$2NLM Chemicals$$aLGI1 protein, human
000283118 650_7 $$2NLM Chemicals$$aanti-leucine-rich glioma-inactivated 1 autoantibody
000283118 650_7 $$2NLM Chemicals$$aIntracellular Signaling Peptides and Proteins
000283118 650_2 $$2MeSH$$aHumans
000283118 650_2 $$2MeSH$$aFemale
000283118 650_2 $$2MeSH$$aMale
000283118 650_2 $$2MeSH$$aMiddle Aged
000283118 650_2 $$2MeSH$$aRetrospective Studies
000283118 650_2 $$2MeSH$$aAdult
000283118 650_2 $$2MeSH$$aAged
000283118 650_2 $$2MeSH$$aEpilepsy: etiology
000283118 650_2 $$2MeSH$$aEpilepsy: epidemiology
000283118 650_2 $$2MeSH$$aAutoantibodies: blood
000283118 650_2 $$2MeSH$$aSeizures: etiology
000283118 650_2 $$2MeSH$$aEncephalitis: complications
000283118 650_2 $$2MeSH$$aEncephalitis: immunology
000283118 650_2 $$2MeSH$$aAutoimmune Diseases of the Nervous System: complications
000283118 650_2 $$2MeSH$$aAutoimmune Diseases of the Nervous System: immunology
000283118 650_2 $$2MeSH$$aAutoimmune Diseases of the Nervous System: therapy
000283118 650_2 $$2MeSH$$aLimbic Encephalitis: complications
000283118 650_2 $$2MeSH$$aLimbic Encephalitis: immunology
000283118 650_2 $$2MeSH$$aFollow-Up Studies
000283118 650_2 $$2MeSH$$aIntracellular Signaling Peptides and Proteins: immunology
000283118 650_2 $$2MeSH$$aYoung Adult
000283118 7001_ $$00009-0004-2505-3069$$aFreyberg, Moritz$$b1
000283118 7001_ $$00000-0003-3415-6428$$aCampetella, Lucia$$b2
000283118 7001_ $$00000-0003-0279-7140$$aCrijnen, Yvette$$b3
000283118 7001_ $$00009-0002-4114-3748$$aDargvainiene, Justina$$b4
000283118 7001_ $$00000-0002-9310-3804$$aBehning, Charlotte$$b5
000283118 7001_ $$00000-0003-2225-8654$$aBien, Christian G$$b6
000283118 7001_ $$00000-0003-2538-0786$$aRada, Anna$$b7
000283118 7001_ $$0P:(DE-2719)2810931$$aPrüss, Harald$$b8
000283118 7001_ $$0P:(DE-2719)9001490$$aRössling, Rosa$$b9
000283118 7001_ $$00000-0002-2500-6893$$aKovac, Stjepana$$b10
000283118 7001_ $$00000-0002-7080-6769$$aStrippel, Christine$$b11
000283118 7001_ $$00000-0001-6548-0410$$aThaler, Franziska S$$b12
000283118 7001_ $$00000-0001-6448-3126$$aEisenhut, Katharina$$b13
000283118 7001_ $$00000-0002-9272-529X$$aLewerenz, Jan$$b14
000283118 7001_ $$aBecker, Felicitas$$b15
000283118 7001_ $$00000-0001-8852-7234$$aReinecke, Raphael$$b16
000283118 7001_ $$00000-0003-2535-4553$$aMalter, Michael Peter$$b17
000283118 7001_ $$00000-0002-8077-481X$$aSühs, Kurt-Wolfram$$b18
000283118 7001_ $$00000-0001-9149-3071$$aTauber, Simone C$$b19
000283118 7001_ $$00000-0002-3134-8697$$aVon Podewils, Felix$$b20
000283118 7001_ $$00000-0002-2420-701X$$aMelzer, Nico$$b21
000283118 7001_ $$00000-0002-5483-4276$$aWandinger, Klaus-Peter$$b22
000283118 7001_ $$aFernandez Ceballos, Romina-Anna-Maria$$b23
000283118 7001_ $$00000-0002-6963-8892$$aKuhle, Jens$$b24
000283118 7001_ $$00000-0001-8966-3684$$aBerger, Klaus$$b25
000283118 7001_ $$0P:(DE-2719)9002598$$aBauer, Tobias$$b26
000283118 7001_ $$00000-0002-6180-7671$$aRüber, Theodor$$b27
000283118 7001_ $$00000-0002-5952-8294$$aRacz, Attila$$b28
000283118 7001_ $$00000-0003-2661-3705$$aBecker, Albert J$$b29
000283118 7001_ $$00000-0002-6688-4916$$aPitsch, Julika$$b30
000283118 7001_ $$aKuhlenbäumer, Gregor$$b31
000283118 7001_ $$00000-0001-5958-3288$$aMuñiz-Castrillo, Sergio$$b32
000283118 7001_ $$00000-0002-4721-5952$$aHonnorat, Jerome$$b33
000283118 7001_ $$00000-0002-1033-3840$$aTitulaer, Maarten J$$b34
000283118 7001_ $$00000-0002-8972-515X$$aLeypoldt, Frank$$b35
000283118 7001_ $$00000-0002-3177-8582$$aSurges, Rainer$$b36
000283118 7001_ $$agroup, and the GENERATE study$$b37$$eCollaboration Author
000283118 773__ $$0PERI:(DE-600)2767740-0$$a10.1212/NXI.0000000000200469$$gVol. 12, no. 6, p. e200469$$n6$$pe200469$$tNeurology: Neuroimmunology & Neuroinflammation ; official journal of the American Academy of Neurology$$v12$$x2332-7812$$y2025
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