{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T21:56:47Z","timestamp":1772229407506,"version":"3.50.1"},"reference-count":51,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2023,7,4]],"date-time":"2023-07-04T00:00:00Z","timestamp":1688428800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Seizures are a common manifestation of paraneoplastic neurologic syndromes. The objective of this study was to describe the seizure characteristics and outcomes in patients with high\u2010risk paraneoplastic autoantibodies (&gt;70% cancer association) and to determine factors associated with ongoing seizures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients from 2000 to 2020 with seizures and high\u2010risk paraneoplastic autoantibodies were retrospectively identified. Factors associated with ongoing seizures at last follow\u2010up were evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixty patients were identified (34 males, median age at presentation\u2009=\u200952\u2009years). ANNA1\u2010IgG (Hu; <jats:italic>n<\/jats:italic>\u2009=\u200924, 39%), Ma2\u2010IgG (<jats:italic>n<\/jats:italic>\u2009=\u200914, 23%), and CRMP5\u2010IgG (CV2; <jats:italic>n<\/jats:italic>\u2009=\u200911, 18%) were the most common underlying antibodies. Seizures were the initial presenting symptom in 26 (43%), and malignancy was present in 38 (63%). Seizures persisted for &gt;1\u2009month in 83%, and 60% had ongoing seizures, with almost all patients (55\/60, 92%) still being on antiseizure medications at last follow\u2010up a median of 25\u2009months after seizure onset. Ongoing seizures at last follow\u2010up were associated with Ma2\u2010IgG or ANNA1\u2010IgG compared to other antibodies (<jats:italic>p<\/jats:italic>\u2009=\u2009.04), highest seizure frequency being at least daily (<jats:italic>p<\/jats:italic>\u2009=\u2009.0002), seizures on electroencephalogram (EEG; <jats:italic>p<\/jats:italic>\u2009=\u2009.03), and imaging evidence of limbic encephalitis (LE; <jats:italic>p<\/jats:italic>\u2009=\u2009.03). Death occurred in 48% throughout the course of follow\u2010up, with a higher mortality in patients with LE than in those without LE (<jats:italic>p<\/jats:italic>\u2009=\u2009.04). Of 31 surviving patients at last follow\u2010up, 55% continued to have intermittent seizures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>Seizures in the setting of high\u2010risk paraneoplastic antibodies are frequently resistant to treatment. Ongoing seizures are associated with ANNA1\u2010IgG and Ma2\u2010IgG, high seizure frequency, and EEG and imaging abnormalities. Although a subset of patients may respond to immunotherapy and achieve seizure freedom, poor outcomes are frequently encountered. Death was more common among patients with LE.<\/jats:p><\/jats:sec>","DOI":"10.1111\/epi.17695","type":"journal-article","created":{"date-parts":[[2023,6,27]],"date-time":"2023-06-27T10:49:52Z","timestamp":1687862992000},"page":"2385-2398","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Seizure characteristics and outcomes in patients with neurological conditions related to high\u2010risk paraneoplastic antibodies"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8659-3801","authenticated-orcid":false,"given":"Kelsey M.","family":"Smith","sequence":"first","affiliation":[{"name":"Department of Neurology Mayo Clinic  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey W.","family":"Britton","sequence":"additional","affiliation":[{"name":"Department of Neurology Mayo Clinic  Rochester Minnesota 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