Paediatric antibody prevalence in seizure score to predict autoimmune aetiology in seizure disorders.

Autor: Mori T; Department of Brain & Neurosciences, Tokyo metropolitan Institute of Medical Science, Tokyo, Japan., Matsuda S; Department of Brain & Neurosciences, Tokyo metropolitan Institute of Medical Science, Tokyo, Japan., Nishida H; Department of Brain & Neurosciences, Tokyo metropolitan Institute of Medical Science, Tokyo, Japan., Kohyama K; Department of Brain & Neurosciences, Tokyo metropolitan Institute of Medical Science, Tokyo, Japan., Fukuda M; Department of Neuropediatrics, Tokyo Metropolitan Neurological Hospital, Tokyo, Japan., Sakuma H; Department of Brain & Neurosciences, Tokyo metropolitan Institute of Medical Science, Tokyo, Japan.
Jazyk: angličtina
Zdroj: Developmental medicine and child neurology [Dev Med Child Neurol] 2024 Apr 19. Date of Electronic Publication: 2024 Apr 19.
DOI: 10.1111/dmcn.15927
Abstrakt: Aim: To modify the antibody prevalence in epilepsy (APE) score of children with suspected autoimmune central nervous system disease with seizures.
Methods: We retrospectively analysed the cerebrospinal fluid of 157 children (aged 0-18 years) with suspected autoimmune central nervous system disease for antineuronal antibodies in our laboratory from 2016 to 2023. Participants were randomly divided into the development cohort (n = 79, 35 females; median 7 years, SD 4 years 7 months, range 4-11 years) and validation cohort (n = 78, 28 females; median 7 years, SD 4 years 5 months, range 4-12 years). A paediatric antibody prevalence in seizure (PAPS) score was created for one cohort and evaluated in the other. Seven variables were selected through univariate and multivariate analysis to create a PAPS score.
Results: One hundred and fifty-seven children who fulfilled the inclusion criteria were enrolled; 49 tested positive for antineuronal antibodies. The sensitivity and specificity of an APE score of 4 and greater were 92% and 22.2% respectively; the sensitivity and specificity of a PAPS score of 2.5 and greater were 83.3% and 77.8% respectively. The area under the curve was 0.832 (95% confidence interval = 0.743-0.921), which was significantly better than that for the APE score (p < 0.001).
Interpretation: The APE score had high sensitivity but low specificity in children. The PAPS score may be useful for determining the need for antineuronal antibody testing.
(© 2024 Mac Keith Press.)
Databáze: MEDLINE
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