言語種別	英語
発表タイトル	Clinical Features of Autoimmune Epilepsy: Seizure Outcomes in a Multicenter Observational Study
会議名	第66回日本神経学会学術大会
学会区分	全国規模の学会
発表形式	口頭
講演区分	一般
発表者・共同発表者	◎戸島麻耶, 下竹昭寛, 林梢, 坂本光弘, 原敦, 千原典夫, 金澤恭子, 荒木保清, 郷治洋子, 三枝隆博, 井内盛遠, 吉村元, 向野隆彦, 重藤寛史, 小林勝哉, 宇佐美清英, 松本理器, 近藤誉之, 池田昭夫
発表年月日	2025/05/22
開催地 （都市, 国名）	大阪
開催期間	2025/05/21～2025/05/24
概要	Purpose: Autoimmune epilepsy due to autoimmune mechanisms, has recently attracted attention. We proposed a diagnostic algorithm and conducted a multicenter observational study to elucidate its pathogenesis and clinical features. Methods: From 2011 to 2023, we included patients suspected of autoimmune epilepsy with a 6-month follow-up. Inclusion criteria were: 1) epilepsy with at least one seizure (Sz) per month or two subclinical Szs on EEG, 2) one or more clinical features suggesting autoimmune mechanisms (acute onset Szs despite antiseizure medication (ASM), multiple Sz semiology or faciobrachial dystonic Szs, autonomic symptoms, a history of autoimmune disease, malignant tumors, or prior viral infections), and 3) one or more abnormal findings (CSF, EEG, brain MRI, or FDG-PET/SPECT) indicative of an autoimmune mechanism. We evaluated the clinical characteristics using univariate analysis with the following outcomes at 6 months: i) >50% reduction in Sz frequency and ii) Sz remission. Results: Seventy-six patients were included. Anti-neural antibodies were positive in 29 patients (38%): 13 for LGI-1, 6 for NMDAR, 4 for GAD, and 7 for others. ASM was administered to 74 patients (97%) and immunotherapy to 55 (72%). At 6-month follow-up, 53 patients (70%) had >50% Sz reduction and 29 patients (38%) had Sz remission. The Sz >50% reduction and remission group both had fewer patients with bilateral epileptic discharges on EEG. Conclusion: In patients with suspected autoimmune epilepsy, bilateral epileptic discharges on EEG may be associated with intractable Szs after 6 months.