Triaging patients with epilepsy at risk of autoimmune encephalitis

Takeaway

  • There are specific signs that indicate whether a person with focal epilepsy of unknown origin and no other symptoms is at risk of autoimmune encephalitis (AIE); the ACES score created in this study can be used to select those at risk of AIE and that need cerebrospinal fluid antibody testing.

Why this matters

  • AIE is a serious condition marked by seizures, cognitive symptoms, behavioral change and autonomic dysfunction. Seizures in AIE are often responsive to immunotherapy but resistant to anti-seizure medications.

  • Underdiagnosis of AIE is likely in patients with neuronal-antibody positive epilepsy and no other symptoms of encephalitis. Early diagnosis of these patients is essential but currently challenging.