@article{1a83cffb1473458c93cd74cbfb98a802,
title = "Prevalence, risk factors, and prognosis of drug-resistant epilepsy in autoimmune encephalitis",
abstract = "Objective: To evaluate the prevalence and biomarkers of drug-resistant epilepsy (DRE) in patients with autoimmune encephalitis (AIE). Methods: Sixty-nine patients with AIE were recruited retrospectively and electroencephalographies (EEGs) were reviewed using a standard reporting proforma. Associations between EEG biomarkers and DRE development at 12 months were examined using logistic regression modeling and were utilized to create a DRE risk score. Results: Sixteen percent of patients with AIE developed DRE at 12-month follow-up. The presence of status epilepticus (SE) (OR 11.50, 95% CI [2.81, 51.86], p-value <0.001), temporal lobe focality (OR 9.90, 95% CI [2.60, 50.71], p-value 0.001) and periodic discharges (OR 19.12, 95% CI [3.79, 191.10], p-value 0.001) on the admission EEG were associated with the development of DRE at 12 months. These variables were utilized to create a clinically applicable risk score for the prediction of DRE development. Conclusions: Drug-resistant epilepsy is an infrequent complication of AIE. Electroencephalography changes during the acute illness can predict the risk of DRE at 12 months post-acute AIE. Significance: The identified EEG biomarkers provide the basis to generate a clinically applicable prediction tool which could be used to inform treatment, prognosis, and select patients for acute treatment trials.",
keywords = "Autoimmune encephalitis, Drug-resistant epilepsy, Electroencephalogram, Prognosis, Status epilepticus",
author = "Robb Wesselingh and James Broadley and Katherine Buzzard and David Tarlinton and Udaya Seneviratne and Chris Kyndt and Jim Stankovich and Paul Sanfilippo and Cassie Nesbitt and Wendyl D'Souza and Richard Macdonell and Helmut Butzkueven and O'Brien, {Terence J.} and Mastura Monif",
note = "Funding Information: A/Prof Wendyl D{\textquoteright}Souza{\textquoteright}s salary is part-funded by The University of Melbourne. He has received travel, investigator-initiated, scientific advisory board and speaker honoraria from UCB Pharma Australia & Global; investigator-initiated, scientific advisory board, travel and speaker honoraria from Eisai Australia & Global; advisory board honoraria from Liva Nova; educational grants from Novartis Pharmaceuticals, Pfizer Pharmaceuticals and Sanofi-Synthelabo; educational; travel and fellowship grants from GSK Neurology Australia, and honoraria from SciGen Pharmaceuticals. Funding Information: Prof Helmut Butzkueven{\textquoteright}s institution receives funding from Biogen, Roche, Merck and Novartis for speaker engagements, study steering and advisory committee service. He is on the editorial board of Multiple Sclerosis and Related Disorders and the Steering committee of the Brain Health Initiative (Oxford Health Policy Forum). Funding Information: We acknowledge the contributions made by Callum Hollis, Ramja Kokulan, Patrick Carney, Annie Roten, and John Archer for their assistance in the procurement and review of EEG data, and the Australian Autoimmune Encephalitis Consortium for their support of the project. RW contributed to the conception and design, acquisition and analysis of data, and drafting a significant portion of the manuscript or figures. MM contributed to the conception and design and drafting a significant portion of the manuscript or figures. HB, DT, TJOB, and KB contributed to the conception and design. CK, JS, PS, CN, WDS, RM, JB, and US contributed to acquisition and analysis of data. A/Prof Wendyl D'Souza{\textquoteright}s salary is part-funded by The University of Melbourne. He has received travel, investigator-initiated, scientific advisory board and speaker honoraria from UCB Pharma Australia & Global; investigator-initiated, scientific advisory board, travel and speaker honoraria from Eisai Australia & Global; advisory board honoraria from Liva Nova; educational grants from Novartis Pharmaceuticals, Pfizer Pharmaceuticals and Sanofi-Synthelabo; educational; travel and fellowship grants from GSK Neurology Australia, and honoraria from SciGen Pharmaceuticals. Prof Richard Macdonell reports no disclosures. Prof Helmut Butzkueven's institution receives funding from Biogen, Roche, Merck and Novartis for speaker engagements, study steering and advisory committee service. He is on the editorial board of Multiple Sclerosis and Related Disorders and the Steering committee of the Brain Health Initiative (Oxford Health Policy Forum). Prof Terence J. O'Brien receives research funding from Biogen, UCB Pharma, Eisai Pharma, Anavex Pharmaceuticals, Zynerba Pharmaceuticals, and serves on the scientific advisory boards for UCB Pharma, Eisai Pharmaceuticals, Zynerba Pharmaceuticals, ES Therapeutics, Seqirus Pharmaceuticals. Dr Mastura Monif's has served on the advisory board for Merck, and has received speaker honoraria from Merck and Biogen. Her institution receives funding from Merck, Australian. National Health Medical Research Council, Brain Foundation, Charles and Sylvia. Viertel Foundation, and MS Research Australia. The remaining authors report no conflicts of interest. Publisher Copyright: {\textcopyright} 2022 Elsevier Inc.",
year = "2022",
month = jul,
doi = "10.1016/j.yebeh.2022.108729",
language = "English",
volume = "132",
journal = "Epilepsy & Behavior",
issn = "1525-5050",
publisher = "Academic Press",
}