Antiphospholipid and antinuclear antibodies in patients with epilepsy or new-onset seizure disorders

PURPOSE: The increased prevalence of autoantibodies in patients with epilep sy has been traditionally regarded to be a consequence of antiepileptic dru gs. The purpose of this study was to measure autoantibodies in well-defined groups of patients with seizures to determine the effects of epilepsy and antiepileptic medications on the presence of autoantibodies. PATIENTS AND METHODS: We studied the frequency of antinuclear antibodies, a nti-beta2-glycoprotein I antibodies, and anticardiolipin antibodies in 50 p atients with therapy-resistant localization-related epilepsy, 50 patients w ith generalized epilepsy syndromes, 52 patients with a newly diagnosed seiz ure disorder but no antiepileptic medication, and 83 healthy controls. RESULTS: Compared with controls, newly diagnosed patients had a significant ly greater prevalence of immunoglobulin (Ig) G class anticardiolipin antibo dies (21% versus 7%); the prevalence was 14% in patients with localization- related epilepsy and 8% in patients with generalized epilepsy. The prevalen ce of IgM class anticardiolipin antibodies was significantly greater in all seizure groups (60% in localization-related epilepsy, 42% in generalized e pilepsies, and 33% in newly diagnosed patients) compared with controls (7%) . Antinuclear antibodies were significantly more common in newly diagnosed patients (21%) and localization-related epilepsy (24%) compared with contro ls (12%). When patients with generalized epilepsy (8%) were used as the ref erence group, antinuclear antibodies were also significantly more frequent in localization-related epilepsy (relative risk [RR] = 2.9, 95% confidence interval [CI]: 1.1 to 8.2) and newly diagnosed seizures (RR = 3.4, 95% CI: 1.2 to 9.3). There were no consistent associations between autoantibodies a nd specific antiepileptic medications. CONCLUSIONS: The prevalence of autoantibodies is greater in patients with e pilepsy, including newly diagnosed seizure disorder. The increased prevalen ce of autoantibodies is more strongly associated with epilepsy than with an tiepileptic drugs, perhaps indicating that immune dysregulation map be comm only associated with epilepsy. Am I Med. 2000;109:712-717. (C) 2000 by Exce rpta Medica, Inc.