The study aims to generate a score to assess the clinical features that help identify the surface-directed autoantibodies in subjects with new-onset focal epilepsy. It also aims to understand immunotherapy’s value.

It is a prospective study of autoantibody evaluation in 219 patients having new-onset focal epilepsy.

10.53% of the subjects (23 adults) had detectable serum autoantibodies. 9 out of those individuals had encephalitis. None of the patients were without autoantibodies. The study identified six elements that will help to predict the autoantibody positivity, namely, age, lowered self-reported mood, ictal piloerection, MRI limbic changes, conventional risk factor absence, and decreased attention. 79% (11 out of 14) of the subjects had detectable autoantibodies, but no encephalitis. They showed superior outcomes than those with confirmed encephalitis.

Mood phenotype, inflammatory investigation, cognitive phenotypes, and seizure semiology help to identify the surface autoantibodies. The outcome of the treatment was excellent in those without the condition but with positive autoantibody. Thus, the study recommends that the healthcare provider should offer the treatment based on the encephalitis’ clinical features and not the presence of positive autoantibody. According to this study, the immunotherapy-responsive epilepsy syndromes with positive autoantibodies come under autoimmune encephalitis.

Ref: https://jnnp.bmj.com/content/early/2020/11/29/jnnp-2020-325011