Movement disorders phenomenology in focal motor seizures

Fasano, Alfonso; Bonaventura, Carlo Di; Bove, Francesco; Espay, Alberto J.; Morgante, Francesca; Fabbrini, Giovanni; Munhoz, Renato P.; Andrade, Danielle M.; Borlot, Felippe; Bui, Esther; Gennaro, Giancarlo Di; Iorio, Raffaele; Katzberg, Hans D.; Luigetti, Marco; Striano, Pasquale; Defazio, Giovanni; Berardelli, Alfredo

doi:10.1016/j.parkreldis.2018.10.021

Cited by 10 publications

(6 citation statements)

References 28 publications

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“…FBDS is a distinctive manifestation of anti-LGI1 encephalitis and was presented in 67% of the patients in this study. Whether it is one kind of seizure or a paroxysmal movement disorder is unknown (21,22). These results are in accordance with previous reports (23,24).…”

Section: Discussionsupporting

confidence: 91%

Clinical Features and Gut Microbial Alterations in Anti-leucine-rich Glioma-Inactivated 1 Encephalitis—A Pilot Study

Wang

et al. 2020

Front. Neurol.

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Anti-leucine-rich glioma-inactivated 1 (anti-LGI1) encephalitis is a rare autoimmune encephalitis (AE). We investigated the clinical features and gut microbial alterations of anti-LGI1 encephalitis. Fifteen patients newly diagnosed with anti-LGI1 encephalitis were recruited in the study prior to the administration of immunotherapy. The control group contains 25 well-matched healthy controls (HCs). All participants were Han Chinese from South China. Their clinical data and fecal samples were collected. The diversity and composition of gut microbiota were analyzed by 16S ribosomal RNA (16S rRNA) gene sequencing. The results showed that anti-LGI1 encephalitis was characterized by cognitive impairment, faciobrachial dystonic seizures, hyponatremia, and psychiatric symptoms. Abnormal EEG and brain MRI were presented in 9 and 10 patients, respectively. Compared to HCs, the anti-LGI1 encephalitis patients exhibited a decreased microbial diversity and an altered overall composition of gut microbiome. At the phylum level, anti-LGI1 encephalitis patients exhibited a higher abundance of Proteobacteria and a lower abundance of Firmicutes. The alterations in the phylum level were associated with autoimmune and inflammatory disorders. At the genus level, there was an increase in Sphingomonas, Anaerofustis, Succinvibrio, Clostridium, and SMB53 (genera related to movement disorders, psychiatric diseases, and with proinflammatory effects). However, the Faecalibacterium, Roseburia, Lachnospira, Ruminococcus, and Blautia [genera with ability to produce short-chain fatty acids (SCFAs)] were obviously reduced in the patient group. Our results suggest that anti-LGI1 encephalitis is characterized by special clinical features and is accompanied by alterations in specific gut microbiota. For the limited sample size and non-applicability to other populations, further studies are warranted to explore the relationships between gut microbiota and anti-LGI1 encephalitis.

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Section: Discussionsupporting

confidence: 91%

Clinical Features and Gut Microbial Alterations in Anti-leucine-rich Glioma-Inactivated 1 Encephalitis—A Pilot Study

Wang

et al. 2020

Front. Neurol.

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“…The overlaps between movement disorders and epilepsy have received growing attention in the past few years [1]. At the molecular level, an increasing number of genetic epilepsies presenting with movement disorders are now recognized [2]; at the clinical level, it has been recently documented that motor seizures can present with a phenomenology fulfilling diagnostic criteria for movement disorders [3].…”

Section: Introductionmentioning

confidence: 99%

Antiseizure Drugs and Movement Disorders

Sáenz‐Farret

Tijssen

Eliashiv³

et al. 2022

CNS Drugs

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The relationship between antiseizure drugs and movement disorders is complex and not adequately reviewed so far. Antiseizure drugs as a treatment for tremor and other entities such as myoclonus and restless leg syndrome is the most common scenario, although the scientific evidence supporting their use is variable. However, antiseizure drugs also represent a potential cause of iatrogenic movement disorders, with parkinsonism and tremor the most common disorders. Many other antiseizure drug-induced movement disorders are possible and not always correctly identified. This review was conducted by searching for all the possible combinations between 15 movement disorders (excluding ataxia) and 24 antiseizure drugs. The main objective was to describe the movement disorders treated and worsened or induced by antiseizure drugs. We also summarized the proposed mechanisms and risk factors involved in the complex interaction between antiseizure drugs and movement disorders. Antiseizure drugs mainly used to treat movement disorders are clonazepam, gabapentin, lacosamide, levetiracetam, oxcarbazepine, perampanel, phenobarbital, pregabalin, primidone, topiramate, and zonisamide. Antiseizure drugs that worsen or induce movement disorders are cenobamate, ethosuximide, felbamate, lamotrigine, phenytoin, tiagabine, and vigabatrin. Antiseizure drugs with a variable effect on movement disorders are carbamazepine and valproate while no effect on movement disorders has been reported for brivaracetam, eslicarbazepine, lacosamide, and stiripentol. Although little information is available on the adverse effects or benefits on movement disorders of newer antiseizure drugs (such as brivaracetam, cenobamate, eslicarbazepine, lacosamide, and rufinamide), the evidence collected in this review should guide the choice of antiseizure drugs in patients with concomitant epilepsy and movement disorders. Finally, these notions can lead to a better understanding of the mechanisms involved in the pathophysiology and treatments of movement disorders.

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“…First, there might be an inevitable recall bias due to the retrospective nature of the study. For example, the symptom of dyskinesia might be related to confounding from the paroxysmal and confusing features and thus easily be ignored without records or marked as seizure [26,27]. Secondly, our study included a limited number of subtypes of AE that are known to be associated with neuronal surface antibodies, with the majority of these presenting with a mild severity.…”

Section: Discussionmentioning

confidence: 99%

Validation of the Clinical Assessment Scale for Autoimmune Encephalitis: A Multicenter Study

et al. 2021

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Introduction: A new scale, named the Clinical Assessment Scale for Autoimmune Encephalitis (CASE), has recently been developed for rating the severity of autoimmune encephalitis (AE) with a high level of clinimetric properties. In this study, our primary objective was to validate the performance of CASE through a multicenter study in China.Methods: Between July 2014 and December 2019, 143 consecutive patients with definite neuronal surface antibody-associated AE from three tertiary hospitals were enrolled in the study. We validated the reliability, internal consistency, and validity of CASE. We further compared CASE with the modified Rankin scale (mRS) among different subtypes of AE in terms of its sensitivity to disease dynamics. Statistical analyses were performed using GraphPad Prism and R software. Results: Our analyses showed that CASE had good inter-and intraobserver reliability (intraclass correlation coefficient 0.96/0.98) and internal consistency (Cronbach a = 0.847) at disease onset. The scores of CASE and mRS remained well correlated in patients at admission and at discharge (both r = 0.80, p \ 0.001). From admission to discharge, the scores of CASE changed in 81 (56.6%) patients, in comparison to changes in mRS in 48 (33.6%) patients (p = 0.007 and p \ 0.001, respectively). The largest changes in scores occurred for non-motor symptoms, including psychiatric, memory, and language dysfunctions (40.6, 26.6, and 23.1% of patients, respectively); in contrast, scores for motor symptoms, such as dyskinesia, weakness and ataxia, changed the least (7.0, 15.4, and 16.1% of patients, respectively). Conclusion:Based on these results, CASE performed well in assessing the severity of neuronal surface antibody-associated AE. In comparison to mRS, it performed better for Meng-Ting Cai and Qi-Lun Lai contributed equally to this work.

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Movement disorders phenomenology in focal motor seizures

Cited by 10 publications

References 28 publications

Clinical Features and Gut Microbial Alterations in Anti-leucine-rich Glioma-Inactivated 1 Encephalitis—A Pilot Study

Clinical Features and Gut Microbial Alterations in Anti-leucine-rich Glioma-Inactivated 1 Encephalitis—A Pilot Study

Antiseizure Drugs and Movement Disorders

Validation of the Clinical Assessment Scale for Autoimmune Encephalitis: A Multicenter Study

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