Abstract Details

Title Understanding Correlation of Electroclinical Findings with Functional and Neuropsychiatric Outcomes in Patients with LGI1-Encephalitis

Topic Autoimmune Neurology

Presentation(s) P2 - Poster Session 2 (9:00 AM-3:00 PM)

Poster/Presentation
Number 035

Objective To evaluate the interplay between seizures, quality of life (QoL), and neuropsychiatric outcomes in patients with leucine-rich glioma-inactived 1 antibody encephalitis (LGI1-Ab-E).

Background Patients with LGI1-Ab-E experience varied seizure semiologies, but their potential differing impact on long-term outcomes remains under-explored.

Design/Methods We conducted a single-center retrospective cohort study of patients with antibody-confirmed LGI1-Ab-E with seizures. Patients were categorized as having faciobrachial dystonic seizures (FBDS) or non-faciobrachial dystonic seizures (non-FBDS). Patient Health Questionnaire-9 (PHQ-9), Neuro-QoL, Patient Reported Outcomes Measurement Information System (PROMIS), and modified Rankin Scale (mRS) were abstracted. Outcomes were compared using two-tailed independent sample t-tests for continuous variables and chi-square and Fisher’s exact test for categorical variables. Change over time was evaluated using Wilcoxon signed-rank test.

Results 21 patients (33% female, median 65 years) were included, 10 (47.6%) with FBDS and 11 (53.4%) with non-FBDS. Levetiracetam (66%,), lacosamide (42.9%), and valproate (19.0%) were the most common anti-seizure medications; 19 (90.5%) underwent immunotherapy. In patients with at least one year of follow-up, all patients with FBDS (n=7) and 75% with non-FBDS (n=6) achieved seizure freedom (p=0.48). From 8 months to 30 months post-diagnosis, PHQ-9 improved in the FBDS cohort (median 6, IQR 5.5—9.5 to median 2.5, IQR 2.0—4.5, p=0.06), but remained stable in the non-FBDS cohort (median 5.5, IQR 2.3—9.3 to median 5, IQR 3.0 to 8.0, p=0.75). Both groups had similar mRS baselines (median mRS 1 for both, p=0.91) and experienced similar significant mRS worsening at median 23 months post-symptoms onset (median increase 1, p <0.001 over time). Neuro-QoL and PROMIS scores were similar between groups (for all, p > .05).

Conclusions Patients with LGI1-Ab-E who experience exclusively non-FBDS may be at higher risk of sustained depressive symptoms than those with FBDS. Regardless of seizure type, patients with LGI1-Ab-E are at risk for significantly worsening disability despite treatment and seizure freedom.

Authors/Disclosures
Carol Swetlik, MD (Cleveland Clinic) PRESENTER	An immediate family member of Dr. Swetlik has received personal compensation for serving as an employee of Pfizer. Dr. Swetlik has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genetech. Dr. Swetlik has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amgen.
Amy Kunchok, MBBS (Cleveland Clinic - Mellen Centre)	Dr. Kunchok has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neurology:Open Access Journal .
Brittany Lapin	No disclosure on file
Yadi Li	No disclosure on file
Vineet Punia, MD (Cleveland Clinic)	Dr. Punia has nothing to disclose.

��ɫ��

��ɫ��