It is significantly challenging to diagnose AIE in individuals with less fulminant disorders, like epilepsy. However, it is important to diagnose for providing immunotherapy. The study helps to identify the antibodies in individuals with focal epilepsy to create a score for testing.

This is a prospective study conducted in multiple centers among adults suffering from unknown etiology focal epilepsy. The study also included a follow-up after one year. Those without AIE were also a part of the study. Different lab techniques helped to analyze CSF (if available) and serum. The factors favoring AES helped to create ACES score using multivariable logistic regression. The Concordance statistics helped to evaluate and validate the model externally.

There were 582 patients with an average of 8 years of epilepsy. 21 patients had AES. The risk factors identified for AES were autoimmune conditions, behavioral changes, temporal MRI-hyperintensities, cognitive symptoms, speech problems, and autonomic symptoms. One point was assigned to each factor, and an ACES score more than or equal to two has 100% sensitivity to detect AES.

The specific risk factors help to diagnose AES in individuals with focal epilepsy. ACES score helps choose individuals who require antibody testing.

Ref: https://onlinelibrary.wiley.com/doi/10.1002/ana.26013