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@ARTICLE{Baumgartner:283118,
      author       = {Baumgartner, Tobias and Freyberg, Moritz and Campetella,
                      Lucia and Crijnen, Yvette and Dargvainiene, Justina and
                      Behning, Charlotte and Bien, Christian G and Rada, Anna and
                      Prüss, Harald and Rössling, Rosa and Kovac, Stjepana and
                      Strippel, Christine and Thaler, Franziska S and Eisenhut,
                      Katharina and Lewerenz, Jan and Becker, Felicitas and
                      Reinecke, Raphael and Malter, Michael Peter and Sühs,
                      Kurt-Wolfram and Tauber, Simone C and Von Podewils, Felix
                      and Melzer, Nico and Wandinger, Klaus-Peter and Fernandez
                      Ceballos, Romina-Anna-Maria and Kuhle, Jens and Berger,
                      Klaus and Bauer, Tobias and Rüber, Theodor and Racz, Attila
                      and Becker, Albert J and Pitsch, Julika and Kuhlenbäumer,
                      Gregor and Muñiz-Castrillo, Sergio and Honnorat, Jerome and
                      Titulaer, Maarten J and Leypoldt, Frank and Surges, Rainer},
      collaboration = {group, and the GENERATE study},
      title        = {{R}isk of {E}pilepsy and {F}actors {A}ssociated {W}ith
                      {T}ime to {S}eizure {R}emission in {A}nti-{LGI}1
                      {E}ncephalitis: {L}ong-{T}erm {O}utcome in 236 {P}atients.},
      journal      = {Neurology: Neuroimmunology $\&$ Neuroinflammation ;
                      official journal of the American Academy of Neurology},
      volume       = {12},
      number       = {6},
      issn         = {2332-7812},
      address      = {Philadelphia, Pa.},
      publisher    = {Wolters Kluwer},
      reportid     = {DZNE-2026-00014},
      pages        = {e200469},
      year         = {2025},
      abstract     = {Autoimmune 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.},
      keywords     = {Humans / Female / Male / Middle Aged / Retrospective
                      Studies / Adult / Aged / Epilepsy: etiology / Epilepsy:
                      epidemiology / Autoantibodies: blood / Seizures: etiology /
                      Encephalitis: complications / Encephalitis: immunology /
                      Autoimmune Diseases of the Nervous System: complications /
                      Autoimmune Diseases of the Nervous System: immunology /
                      Autoimmune Diseases of the Nervous System: therapy / Limbic
                      Encephalitis: complications / Limbic Encephalitis:
                      immunology / Follow-Up Studies / Intracellular Signaling
                      Peptides and Proteins: immunology / Young Adult /
                      Autoantibodies (NLM Chemicals) / LGI1 protein, human (NLM
                      Chemicals) / anti-leucine-rich glioma-inactivated 1
                      autoantibody (NLM Chemicals) / Intracellular Signaling
                      Peptides and Proteins (NLM Chemicals)},
      cin          = {AG Prüß / AG Stöcker},
      ddc          = {610},
      cid          = {I:(DE-2719)1810003 / I:(DE-2719)1013026},
      pnm          = {353 - Clinical and Health Care Research (POF4-353) / 354 -
                      Disease Prevention and Healthy Aging (POF4-354)},
      pid          = {G:(DE-HGF)POF4-353 / G:(DE-HGF)POF4-354},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:40953325},
      pmc          = {pmc:PMC12440303},
      doi          = {10.1212/NXI.0000000000200469},
      url          = {https://pub.dzne.de/record/283118},
}