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N-methyl-D-aspartate receptor autoantibody levels in children with intractable and non-intractable epilepsy

Prastiya Indra Gunawan1, Nurani Widianti1, Riza Noviandi1

  • 1Division of Neurology, Department of Child Health, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.

Heliyon
|September 12, 2024
PubMed

Insights

Autoimmune N-methyl-D-aspartate-receptor (NMDAR) autoantibodies may play a role in childhood epilepsy. While levels were numerically higher in intractable cases, this study found no significant difference between intractable and non-intractable childhood epilepsy groups.

Area of Science:

  • Neurology
  • Immunology
  • Pediatrics

Background:

  • Intractable epilepsy in children is a significant neurological challenge.
  • Autoimmune processes, particularly involving N-methyl-D-aspartate-receptor (NMDAR) autoantibodies, are implicated in epilepsy pathogenesis.
  • Understanding the role of NMDAR autoantibodies is crucial for diagnosing and managing pediatric epilepsy.

Purpose of the Study:

  • To compare N-methyl-D-aspartate-receptor (NMDAR) autoantibody levels in children with intractable epilepsy versus non-intractable epilepsy.
  • To investigate the association between NMDAR autoantibody status and clinical characteristics in pediatric epilepsy patients.

Main Methods:

  • A prospective analytical study was conducted with 75 pediatric epilepsy patients (1 month to 18 years).
  • Patients were categorized into intractable and non-intractable epilepsy groups.
  • N-methyl-D-aspartate-receptor (NMDAR) autoantibody levels were measured using ELISA, with statistical analysis via chi-squared and Wilcoxon-Mann-Whitney tests.

Main Results:

  • N-methyl-D-aspartate-receptor (NMDAR) autoantibodies were detected in 41.3% of intractable epilepsy cases and 33.4% of non-intractable cases.
  • A significant correlation was found between seizure frequency and NMDAR autoantibody positivity (P=0.002).
  • No significant difference in NMDAR autoantibody levels was observed between the intractable and non-intractable epilepsy groups (P=0.157).

Conclusions:

  • N-methyl-D-aspartate-receptor (NMDAR) autoantibody levels were numerically higher in children with intractable epilepsy.
  • While not statistically significant, the trend suggests a potential role for NMDAR autoimmunity in severe pediatric epilepsy.
  • Further research is warranted to elucidate the precise role of NMDAR autoantibodies in pediatric epilepsy.
Abstract

Keywords:
AutoimmuneChildrenDiseaseIntractable epilepsyNMDAR

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