Acute symptomatic seizures secondary to autoimmune encephalitis and autoimmune-associated epilepsy: Conceptual definitions

Epilepsia. 2020 Jul;61(7):1341-1351. doi: 10.1111/epi.16571. Epub 2020 Jun 16.

Abstract

Seizures are a well-recognized and often prominent manifestation of autoimmune encephalitic syndromes. Progress in detection of pathogenic neural autoantibodies has led to increased awareness of autoimmune causes of seizures. Clinical studies of patients with these autoantibodies have improved our understanding of the seizure characteristics, treatments, and seizure prognosis in these disorders. The International League Against Epilepsy (ILAE) Autoimmunity and Inflammation Taskforce proposes conceptual definitions for two main diagnostic entities: (a) acute symptomatic seizures secondary to autoimmune encephalitis, and (b) autoimmune-associated epilepsy, the latter of which suggests an enduring predisposition to seizures. Such a distinction is relevant when discussing the pathophysiology, treatment, prognosis, and social consequences of these disorders. We discuss the role of biomarkers in the application of these conceptual definitions and illustrate their use in patients cared for by members of the task force.

Keywords: autoimmune encephalitis; autoimmune epilepsy; classification; seizures.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Autoantibodies / blood
  • Biomarkers / blood
  • Encephalitis / blood*
  • Encephalitis / complications
  • Encephalitis / diagnosis*
  • Epilepsy / blood*
  • Epilepsy / complications
  • Epilepsy / diagnosis*
  • Female
  • Hashimoto Disease / blood*
  • Hashimoto Disease / complications
  • Hashimoto Disease / diagnosis*
  • Humans
  • Male
  • Middle Aged
  • Seizures / blood*
  • Seizures / diagnosis*
  • Seizures / etiology
  • Young Adult

Substances

  • Autoantibodies
  • Biomarkers

Supplementary concepts

  • Hashimoto's encephalitis