Related Influencing Factors Analysis of Epilepsy Secondary to Anti-N-methyl-D-aspartate Receptor Encephalitis in Children
Objective The current low risk of secondary epilepsy in children recovering from N-methyl-D-aspartate receptor(NMDAR)resistant encephalitis is poorly studied and under-recognized by most clinicians.A comparative study of children with anti-NMDAR encephalitis secondary to epilepsy and non-secondary to epilepsy was conducted to improve clinicians′ understanding of the clinical features and associated factors influencing anti-NMDAR encephalitis and its secondary epilepsy.Methods A retrospective analysis was conducted on the clinical data of 50 children with confirmed anti-NMDAR encephalitis who visited the neurology department of Wuhan Children′s Hospital from January 2015 to January 2022.Based on whether the children had secondary epilepsy at the final follow-up,they were divided into the post-encephalitis epilepsy group(PE group)and the post-encephalitis non-secondary epilepsy group(NO-PE group).Poisson regression analysis was used for statistics.Results The incidence of post-encephalitis epilepsy was 8%(4/50).The male-to-female ratio of 50 children was 0.61∶1.The male-to-female ratio of children with secondary epilepsy was 1∶3.The clinical manifestations of anti-NMDAR encephalitis were diverse,with epilepsy being one of the most common clinical symptoms,accounting for 86%(43/50),of which 64%(32/50)were initiated by epilepsy.Among children with secondary epilepsy,75%(3/4)also had seizures as the first symptom and were more likely to have motor disorders left(50%(2/4))and decreased learning ability left(75%(3/4)).In terms of treatment,most children with encephalitis received immunotherapy,and 74%(37/50)of them were treated with antiepileptic drugs in the acute phase.The head imaging showed there was a statistically significant difference(P<0.05)between the PE group and the NO-PE group in subcortical involvement(75%(3/4)vs.13%(6/46)),involvement of the basal ganglia area(50%(2/4)vs.0%(0/46)),and electroencephalography showing the presence δ brush(50%(2/4))vs.(8.7%(4/46)).Conclusion The clinical symptoms of children with anti-NMDAR encephalitis are diverse,and the incidence of secondary epilepsy is low.Antiepileptic drugs can promptly control seizures after progression to post-encephalitis epilepsy,the children with head imaging showing subcortical involvement,basal ganglia area,and electroencephalogram suggesting the presence δ brush are more likely to develop secondary epilepsy.
万方数据
维普
