Viral encephalitis versus autoimmune encephalitis in clinical features of patients with epileptic seizure

  Objective  To compare the clinical features of viral encephalitis (VE) and autoimmune encephalitis (AE) in patients with epileptic seizure.

  Methods  Clinical materials of hospitalized patients diagnosed as VE or AE in the acute epileptic seizure period in Brain Hospital Affiliated to Nanjing Medical University were selected, and all the patients were followed up by telephone for recurrent epilepsy condition within 1 year after discharge. The clinical data and prognosis were compared between two groups.

  Results  A total of 36 VE and 36 AE patients were included in the study, and there were significant differences in the onset form, antecedent infectious symptoms, disturbance of consciousness, recurrent epilepsy after discharge, leukocyte count in peripheral blood, range of lesions by MRI and severe abnormal electroencephalogram between the two groups (P < 0.05). The incidence of relapse of epilepsy in the AE group was significantly higher than that in the VE group (P < 0.05). Binary Logistic regression analysis showed that onset form, antecedent infectious symptoms and leukocyte count in peripheral blood were factors with statistical difference in clinical characteristics between the VE group and the AE group (P < 0.05).

  Conclusion  There are significant differences between VE and AE in some clinical features and auxiliary inspections in patients with epileptic seizure, which can provide reference for the differential diagnosis of the two kinds of encephalitis in clinical practice, and for the prevention and treatment of epilepsy in advanced stage of disease.