Autoimmune Encephalitis
Conditions
Brief summary
Epilepsy is a disorder of the brain in which people have repeated seizures. Autoimmune encephalitis (AE) is a rare cause of epilepsy. It is an inflammatory disease of the brain. This means that the body's own immune system attacks healthy brain tissue, just like it would if it were infected by a virus or a bacteria, by producing an army of proteins called 'antibodies' which go on to 'attack' healthy tissues. Seizures in AE typically do not respond well to classic 'anti-seizure medications'. Instead, medications which suppress the immune system are used. These can have significant side-effects and some patients will still continue to have seizures or experience a recurrence of AE-related epilepsy despite treatment. It is difficult to accurately predict who will experience these outcomes. This study aims to find ways of predicting and monitoring which people with AE are at greatest risk of these outcomes, so we can better direct them towards appropriate treatments. We will collect clinical information and samples of blood and cerebrospinal fluid (CSF, fluid surrounding the brain and spinal cord) from people with AE and 'control' participants with other neurological illnesses. Samples will be analysed for markers which may help predict or correlate with outcomes in AE and better understand this condition.
Interventions
OTHERObservational study
Observational study
Sponsors
University of Oxford
Royal College of Surgeons, Ireland
Study design
Observational model
COHORT
Time perspective
OTHER
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* AE participants over the age of 18 will be recruited if they meet the criteria for clinically probable or clinically definite Autoimmune Encephalitis as per Graus and colleagues 2016. * Neurological Control participants undergoing lumbar puncture as part of clinical care for other, non-encephalitis disorders (e.g. for investigation of headache where meningitis or encephalitis is not detected, for investigation and treatment of idiopathic intracranial hypertension) in Beaumont hospital will be recruited.
Exclusion criteria
AE participants * Under 18 years of age * Participants without AE or those with a definitive alternate diagnosis for presentation. Other neurological control participants will be excluded if they have a current or historic diagnosis of AE.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Functional status | 1-3 years | Modified Rankin score |
| Seizure frequency | 1-3 years | \>50% improvement in seizure frequency over time |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Clinical status | 1-3 years | As measured by the Clinical Assessment of severity in Autoimmune Encephalitis. |
| Mood/affect | 1-3 years | Measured by the hospital anxiety and depression index |
| Quality of life | 1-3 years | EQ-5D-5L (By EuroQOL, not an abbreviation) |
| Pain | 1-3 years | Patient-Reported Outcomes Measurement Information System (PROMIS) Pain interference short form A |
| Sleep Quality | 1-3 years | Pittsburgh Sleep Quality Index |
| Impulsivity | 1-3 years | Barratt Impulsivity Index |
| Neuropsychiatric symptoms | 1-3 years | Neuropsychiatric Inventory |
| Fatigue | 1-3 years | Fatigue Scale for Motor and Cognitive Funcitons |
| Cognitive ability | 1-3 years | As measured by the Addenbrooke's Cognitive Examination. |
Other
| Measure | Time frame | Description |
|---|---|---|
| Other symptoms | 1-3 years | Qualitiative analysis through semi-structured interview with participants and caregivers. |
Contacts
Primary ContactMark Kelly, MB BCh BAO, MSc, MRCP
Backup ContactNorman Delanty, B.Sc., MB, FRCPI
Outcome results
None listed