Seizures associated with antibodies against cell surface antigens are acute symptomatic and not indicative of epilepsy:
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ORIGINAL COMMUNICATION
Seizures associated with antibodies against cell surface antigens are acute symptomatic and not indicative of epilepsy: insights from long‑term data Anna Rada1 · Robert Birnbacher2 · Claudio Gobbi3,4 · Martin Kurthen5 · Albert Ludolph6 · Markus Naumann7 · Ulrike Neirich8 · Tim J. von Oertzen9 · Gerhard Ransmayr10 · Matthias Riepe11 · Mareike Schimmel12 · Oliver Schwartz13 · Rainer Surges14 · Christian G. Bien1,15 Received: 2 August 2020 / Revised: 25 September 2020 / Accepted: 28 September 2020 © The Author(s) 2020
Abstract Background Clinicians have questioned whether any disorder involving seizures and neural antibodies should be called “(auto)immune epilepsy.” The concept of “acute symptomatic seizures” may be more applicable in cases with antibodies against neural cell surface antigens. We aimed at determining the probability of achieving seizure-freedom, the use of anti-seizure medication (ASM), and immunotherapy in patients with either constellation. As a potential pathophysiological correlate, we analyzed antibody titer courses. Methods Retrospective cohort study of 39 patients with seizures and neural antibodies, follow-up ≥ 3 years. Results Patients had surface antibodies against the N-methyl-d-aspartate receptor (NMDAR, n = 6), leucine-rich glioma inactivated protein 1 (LGI1, n = 11), contactin-associated protein-2 (CASPR2, n = 8), or antibodies against the intracellular antigens glutamic acid decarboxylase 65 kDa (GAD65, n = 13) or Ma2 (n = 1). Patients with surface antibodies reached first seizure-freedom (88% vs. 7%, P
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