Understanding Correlation of Electroclinical Findings With Functional and Neuropsychiatric Outcomes in Patients with LGI1-Encephalitis

Autor: Carol Swetlik, Amy Kunchok, Brittany Lapin, Yadi Li, Vineet Punia
Rok vydání: 2022
Předmět:
Zdroj: Neurology. 99:S51.3-S52
ISSN: 1526-632X
0028-3878
Popis: ObjectiveTo evaluate the interplay between seizures, quality of life (QoL), and neuropsychiatric outcomes in patients with leucine-rich glioma-inactived 1 antibody encephalitis (LGI1-Ab-E).BackgroundPatients with LGI1-Ab-E experience varied seizure semiologies, but their potential differing impact on long-term outcomes remains under-explored.Design/MethodsWe conducted a single-center retrospective cohort study of patients with antibody-confirmed LGI1-Ab-E with seizures. Patients were categorized as having faciobrachial dystonic seizures (FBDS) or non-faciobrachial dystonic seizures (non-FBDS). Patient Health Questionnaire-9 (PHQ-9), Neuro-QoL, Patient Reported Outcomes Measurement Information System (PROMIS), and modified Rankin Scale (mRS) were abstracted. Outcomes were compared using two-tailed independent sample t-tests for continuous variables and chi-square and Fisher's exact test for categorical variables. Change over time was evaluated using Wilcoxon signed-rank test.Results21 patients (33% female, median 65 years) were included, 10 (47.6%) with FBDS and 11 (53.4%) with non-FBDS. Levetiracetam (66%), lacosamide (42.9%), and valproate (19.0%) were the most common anti-seizure medications; 19 (90.5%) underwent immunotherapy. In patients with at least one year of follow-up, all patients with FBDS (n = 7) and 75% with non-FBDS (n = 6) achieved seizure freedom (p = 0.48). From 8 months to 30 months post-diagnosis, PHQ-9 improved in the FBDS cohort (median 6, IQR 5.5—9.5 to median 2.5, IQR 2.0—4.5, p = 0.06), but remained stable in the non-FBDS cohort (median 5.5, IQR 2.3—9.3 to median 5, IQR 3.0 to 8.0, p = 0.75). Both groups had similar mRS baselines (median mRS 1 for both, p = 0.91) and experienced similar significant mRS worsening at median 23 months post-symptoms onset (median increase 1, p < 0.001 over time). Neuro-QoL and PROMIS scores were similar between groups (for all, p > .05).ConclusionsPatients with LGI1-Ab-E who experience exclusively non-FBDS may be at higher risk of sustained depressive symptoms than those with FBDS. Regardless of seizure type, patients with LGI1-Ab-E are at risk for significantly worsening disability despite treatment and seizure freedom.
Databáze: OpenAIRE
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