Antibody prevalence and immunotherapy response in Chinese patients with epilepsy and encephalopathy scores for patients with different neuronal surface antibodies

Abstract Background : Autoimmune epilepsy is recognized as a distinct entity of epilepsy with underestimated incidence. Our previous study reported that prompt diagnosis and early-initiated immunotherapy led to better outcome. We proposed to assess the feasibility and reasonability of the Antibody Prevalence in Chinese Patients with Epilepsy and Encephalopathy (APE 2 -CHN) and Response to Immunotherapy in Chinese Patients with Epilepsy and Encephalopathy (RITE 2 -CHN) scores in predicting Chinese patients with autoimmune epilepsy. Methods : We conducted a retrospective study of consecutive patients from Xiangya Hospital, Central South University (01/01/2017-02/28/2019) whose serum and/or cerebrospinal fluid (CSF) samples were examined for autoimmune encephalitis antibodies. Of these, patients with new-onset epilepsy or established epilepsy of unknown etiology were selected in our study. An APE 2 -CHN score was assigned to each patient and a RITE 2 -CHN score was calculated for each patient who received immunotherapy. Results : 191 patients meeting the diagnostic criteria for epilepsy were enrolled in our study. 36 were subsequently identified with specific etiologies. The rest of the 155 patients had an unknown etiology. Central nervous system-specific antibodies were detected in 76 (49.0%) of them, after excluding solely thyroid peroxidase antibody or glutamic acid decarboxylase antibody. N-methyl-D-aspartate receptor antibody (48.7%, 37/76) was the most common antibody specificity, followed by γ-aminobutyric acid type B receptor antibody (14.5%, 11/76). Certain clinical features such as new-onset epilepsy, autonomic dysfunction, viral prodrome, facio-brachial dystonic seizures/oral dyskinesia, inflammatory CSF profile, and mesial temporal magnetic resonance imaging abnormalities correlated with positive antibody results. Sensitivity and specificity of an APE 2 -CHN score ≥ 5 to predict the presence of specific neural auto-antibodies in our study were 85.5% and 58.9%, respectively. In the subset of patients who received immunotherapy (n = 112), sensitivity and specificity of a RITE 2 -CHN score ≥ 8 to predict favorable seizure outcome were 98.6% and 63.2% respectively. Conclusion : The APE 2 -CHN and RITE 2 -CHN scores were preferable tools in predicting positive serologic findings and prognosis of autoimmune epilepsy in Chinese patients with epilepsy.

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Effects of Comedication and Genetic Factors on the Population Pharmacokinetics of Lamotrigine: A Prospective Analysis in Chinese Patients With Epilepsy

Frontiers in Pharmacology ◽

10.3389/fphar.2019.00832 ◽

2019 ◽

Vol 10 ◽

Cited By ~ 1

Author(s):

Zhan-zhang Wang ◽

Yue-feng Zhang ◽

Wen-can Huang ◽

Xi-pei Wang ◽

Xiao-jiao Ni ◽

...

Keyword(s):

Population Pharmacokinetics ◽

Genetic Factors ◽

Chinese Patients ◽

Prospective Analysis ◽

Patients With Epilepsy

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Effects of EPHX1, SCN1A and CYP3A4 genetic polymorphisms on plasma carbamazepine concentrations and pharmacoresistance in Chinese patients with epilepsy

Epilepsy Research ◽

10.1016/j.eplepsyres.2013.09.011 ◽

2013 ◽

Vol 107 (3) ◽

pp. 231-237 ◽

Cited By ~ 15

Author(s):

Wenting Yun ◽

Feng Zhang ◽

Cheng Hu ◽

Xiaopei Luo ◽

Peng Xue ◽

...

Keyword(s):

Genetic Polymorphisms ◽

Chinese Patients ◽

Patients With Epilepsy

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Simultaneous determination of valproic acid and 2-propyl-4-pentenoic acid for the prediction of clinical adverse effects in Chinese patients with epilepsy

Seizure ◽

10.1016/j.seizure.2011.10.002 ◽

2012 ◽

Vol 21 (2) ◽

pp. 110-117 ◽

Cited By ~ 19

Author(s):

Zhuo-jia Chen ◽

Xue-ding Wang ◽

Hong-sheng Wang ◽

Shu-da Chen ◽

Lie-min Zhou ◽

...

Keyword(s):

Valproic Acid ◽

Adverse Effects ◽

Simultaneous Determination ◽

Chinese Patients ◽

Patients With Epilepsy

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Erratum to: Population pharmacokinetic modeling of oxcarbazepine active metabolite in Chinese patients with epilepsy

European Journal of Drug Metabolism and Pharmacokinetics ◽

10.1007/s13318-016-0379-5 ◽

2016 ◽

Vol 42 (1) ◽

pp. 171-171

Author(s):

Yunli Yu ◽

Quanying Zhang ◽

Wenjun Xu ◽

Chengzhe Lv ◽

Gang Hao

Keyword(s):

Active Metabolite ◽

Pharmacokinetic Modeling ◽

Chinese Patients ◽

Population Pharmacokinetic ◽

Population Pharmacokinetic Modeling ◽

Patients With Epilepsy

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Disease awareness and dietary habits of patients with epilepsy in western China: a cross-sectional study

Acta Epileptologica ◽

10.1186/s42494-021-00065-x ◽

2021 ◽

Vol 3 (1) ◽

Author(s):

Qi Zhang ◽

Wenjing Li ◽

Enzhi Li ◽

Xiao Yang ◽

Nanya Hao ◽

...

Keyword(s):

Antiepileptic Drugs ◽

Seizure Control ◽

Dietary Habits ◽

Cross Sectional Study ◽

Western China ◽

Chinese Patients ◽

Cross Sectional Survey ◽

Cross Sectional ◽

First Choice ◽

Patients With Epilepsy

Abstract Background The optimal management of epilepsy includes engaging patients through education on knowledge of the disease, its treatment and diet control. Methods This was a cross-sectional survey-based cohort study, aimed to investigate the awareness of epilepsy in Chinese patients and to understand their dietary habits. Participants were consecutively enrolled from epileptic patients treated in a single epilepsy center from October 1, 2019 to February 29, 2020. A self-reported questionnaire (Cronbach’s α = 0.758) consisting of 3 parts was sent to 407 patients with epilepsy. The questionnaire included items on demographic information, epilepsy features, awareness of epilepsy treatment and dietary habits. Results About half of the patients (53.8%, 219/407) thought epilepsy was curable and only 80% knew that the first choice of treatment is medication. While 58.6% of the patients with low educational level preferred the use of antiepileptic drugs (p = 0.014), 52.7% believed that the medication should not be stopped immediately after seizure control (p = 0.026), especially after surgery (40.5%, p = 0.011). Patients with lower household monthly incomes had less awareness of the use of antiepileptic drugs than patients with higher incomes: only 39.2 and 49.8% of patients with lower incomes thought that the drugs could be stopped after epilepsy surgery or seizure control, respectively, compared to 51.6 and 66.1% with higher incomes. Alcohol (86.2%), caffeine (56.8%) and strong tea (49.1%) were top three foods considered by the patients to be avoided to prevent seizures. Approximately 30.2% of patients identified at least one food that made them susceptible to seizures. Conclusions Patient education on epilepsy, antiepileptic drugs and diet for management of seizures should be provided especially to patients with less education, lower income or inaccurate beliefs of epilepsy in Western China.

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