Antibodies in Children with New-onset Seizures

In the October 23, 2013, early access view of the journal Epilepsia, Drs. Suleiman and colleagues in Australia present a fascinating study assessing abnormal antibodies in 114 children between the ages of 2 months to 16 years with new-onset seizures, along with 65 children in a control group, between the years 2009 and 2011.

• 9.7% were positive for one or more autoantibodies compared to 3 of 65 controls.
  • Patients had antibodies to the voltage-gated potassium channel complex, contactin-associated protein-like 2, NMDA receptors, or Voltage-gated potassium channel complex and NMDA receptors.
  • None of the patients had antibodies to glutamic acid decarboxylase, contactin-2 or to glycine, or AMPA or GABA receptors.
• There was no significant difference in the demographic and clinical features between antibody-positive and antibody-negative patients.
• Four of the seven patients with epilepsy were classified as having predominantly focal seizures compared to 12 of the 86 antibody-negative patients.

The authors concluded autoantibodies are more frequent in pediatric patients with new-onset epilepsy of unknown cause, often with focal epilepsy features. This group of children may benefit most from autoantibody screening and consideration of immune therapy.