The study aims to understand autoantibody status in a European multi-center cohort with subjects with unknown aetiology of epilepsy. The study also aims to evaluate the APE2 (Antibody Prevalence in Epilepsy) and the RITE2 scores.

The researchers collected data pertaining to 92 patients from Verona and Salzburg, dated between Jan 2014 and Jul 2019. The subjects include unknown aetiology epilepsy, status epilepticus, and new onset of the condition. They conducted live rat hippocampal cell culture, immunoblot, tissue-based  and cell-based (fixed and live) assays on the CSF (cerebrospinal fluid)/serum to identify the antiglial and antineuronal antibodies. The scores of RITE2 and APE2 were calculated and then compared with the lab and clinical data.

The results showed autoantibodies in 29 subjects (31.5%). Multiple positivity was observed in 6 out of those 29 subjects. The APE2 score showed a significant correlation with the antibody positivity for subjects with neuropsychiatric symptoms, dysautonomia, movement disorder, cancer history, and faciobrachial dyskinesias. According to the RITE2 score, the early immunotherapy indication had a significant correlation with the treatment response. After one year, the persistence of symptoms and seizure had a significant correlation with antiepileptic maintenance.

This study successfully validates the RITE2 and APE2 scores. It also showed the possible association of autoantibodies with autoimmune epilepsy.