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Patrones electroencefalográficos y su asociación con el pronóstico funcional en encefalitis autoinmune anti-NMDA

Electroencephalographic patterns and their association with functional prognosis in anti-NMDA autoimmune encephalitis
Authors: Aguilar-Vázquez, Crhistian Alejandro; Ruvalcaba-Sánchez, Nallely Denisse; Hernández-Domínguez, Julián Alberto; et al;

Patrones electroencefalográficos y su asociación con el pronóstico funcional en encefalitis autoinmune anti-NMDA

Abstract

Resumen Introducción: la encefalitis autoinmune es una enfermedad de poca incidencia y prevalencia, pero que presenta altas tasas de incapacidad y puede ser potencialmente mortal. Objetivo: determinar si la presencia de patrones anormales electroencefalográficos en pacientes con encefalitis autoinmune anti-NMDAR afectan con el pronóstico funcional a los 3 meses. Material y métodos: se realizó un estudio retrospectivo, observacional, analítico, longitudinal-transversal, con cohorte retrospectiva. Resultados: de un total de 44 pacientes con encefalitis autoinmune anti-NMDAR. En relación con los hallazgos electroencefalográficos 19 pacientes tuvieron un resultado de EEG normal (43.2%), 18 con disfunción cortical (40.9%), 7 con reporte de epileptiforme (15.9%) y sólo 1 con reporte de delta brush (2.3%). El desenlace funcional de los pacientes a los 3 meses medido por escala de Rankin modificada (mRS) fueron 3 pacientes sin discapacidad (6.8%), 6 pacientes con discapacidad leve (13.6%), 17 pacientes con discapacidad leve a moderada (38.6%), discapacidad moderada a severa en 9 pacientes (20.5%), 1 paciente confinado a cama (2.3%) y 2 con muerte (5.6%). Conclusiones: en nuestro estudio no se logró encontrar una correlación entre un patrón electroencefalográfico anormal con un peor pronóstico funcional a 3 meses, aunque el electroencefalograma que se toma para el análisis es el inicial, habría que valorar posteriormente si es que la persistencia de anormalidad en el electroencefalograma se relaciona con mayor cantidad de secuelas e incapacidad.

Background: Autoimmune encephalitis is a rare disease with low incidence and prevalence but carries high rates of disability and potential fatality. Objective: To determine whether the presence of abnormal electroencephalographic patterns in patients with anti-NMDAR autoimmune encephalitis affects functional prognosis at 3 months. Material and methods: A retrospective, observational, analytical, longitudinal-cross-sectional study was conducted with a retrospective cohort. Results: Out of a total of 44 patients with anti-NMDAR autoimmune encephalitis, concerning electroencephalographic findings, 19 patients had a normal EEG result (43.2%), 18 had cortical dysfunction (40.9%), 7 had epileptiform reports (15.9%), and only 1 had a Delta Brush report (2.3%). The functional outcome of patients at 3 months measured by the modified Rankin Scale (mRS) was as follows: 3 patients without disability (6.8%), 6 patients with mild disability (13.6%), 17 patients with mild to moderate disability (38.6%), 9 patients with moderate to severe disability (20.5%), 1 patient bedridden (2.3%), and 2 deceased (5.6%). Conclusion: In our study, no association was found between an abnormal electroencephalographic pattern and a worse functional prognosis at 3 months in patients with autoimmune encephalitis. Although the electroencephalogram analyzed is the initial one, it would be necessary to assess later whether the persistence of abnormalities in the electroencephalogram is related to a greater number of sequelae and disabilities.

Keywords

Aportación Original, Enfermedades Autoinmunes del Sistema Nervioso; Receptores de N-Metil-D-Aspartato; Pronóstico; Electroencefalograma; Autoimmune Diseases of the Nervous System; Receptors, N-Methyl-D-Aspartate; Prognosis; Electroencephalogram

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
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