Risk factors for the progression to epilepsy following acute-phase autoimmune encephalitis with seizures: A two-center retrospective study.
TL;DR
Among patients with acute-phase AE and seizures, the number of ASMs at discharge and the absence of prodromal infection symptom are probable clinical indicators for predicting AEAE, which may facilitate early risk stratification and optimize management strategies for patients with AE-related seizures.
Abstract
Objective
To investigate the clinical features and risk factors for progression from acute-phase autoimmune encephalitis (AE) with epileptic seizures to autoimmune encephalitis-associated epilepsy (AEAE).
Methods
We retrospectively analyzed clinical data from patients with acute-phase autoimmune encephalitis presenting with seizures between January 2016 and July 2024 at two clinical centers. Following a minimum follow-up of one year, patients were categorized into the ASSAE group or the AEAE group. Multivariable logistic regression identified independent predictors. Model performance was assessed by ROC analysis with bootstrap validation (B = 1000) and calibration testing.
Results
32 patients (22.9%) progressed to AEAE. Multivariable logistic regression identified symptom of prodromal infection as a protective factor (OR: 0.336, 95% CI: 0.131-0.862), while the number of ASMs at discharge was identified as a significant clinical indicator of AEAE development (OR: 2.854, 95% CI: 1.551-5.255). The model demonstrated good discrimination (bootstrap AUC: 0.766, 95% CI: 0.684-0.841) and excellent calibration (Hosmer-Lemeshow P = 0.849).
Conclusion
Among patients with acute-phase AE and seizures, the number of ASMs at discharge and the absence of prodromal infection symptom are probable clinical indicators for predicting AEAE. These findings may facilitate early risk stratification and optimize management strategies for patients with AE-related seizures.