Immunotherapy trials ‘can benefit suspected autoimmune epilepsy patients’

New research has underlined the potential benefits that a trial of immunotherapy can have in the diagnosis and treatment of patients with suspected autoimmune epilepsy.

Conducted by the College of Medicine at the Mayo Clinic in Rochester, Minnesota, the study saw a team of scientists review the charts of 110 patients seen at the institution’s autoimmune neurology clinic with seizures as a chief complaint.

Out of these, a total of 29 patients with frequent or medically intractable seizures were selected after meeting a number of key inclusion criteria, including the suspicion of autoimmune epilepsy based on the presence of neural autoantibodies, a personal or family history or physical signs of autoimmunity.

The selected patients had also initiated a six to 12-week trial of intravenous methylprednisolone, immune globulin or both. Subjects were defined as having responded to treatment if a 50 per cent or greater reduction in seizure frequency was observed.

According to results published in the journal Neurology, a total of 18 patients, or 62 per cent of the group, responded to therapy, with ten of these becoming seizure-free.

Just over half of this group improved with the first agent, while 43 per cent of those receiving a second agent after not responding to the first subsequently saw improvement.

A favourable response tended to correlate with a shorter interval between symptom onset and treatment initiation. Moreover, of the 13 responders followed for more than six months after initiating long-term oral immunosuppressant therapy, the positive response was sustained in 11 of them, equating to an 85 per cent success rate.

“These retrospective findings justify consideration of a trial of immunotherapy in patients with suspected autoimmune epilepsy,” said the researchers.

This could be an important discovery as it has been noted previously that epilepsy patients are often also affected by autoimmune disorders. A recent JAMA Neurology study analysing US insurance claims data on around 2.5 million people revealed that a diagnosis of epilepsy was nearly four times as common among those with some form of autoimmune disease.

Posted by Anne Brown

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