{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,9]],"date-time":"2026-08-09T10:51:50Z","timestamp":1786272710937,"version":"build-2736575974"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,8,12]],"date-time":"2022-08-12T00:00:00Z","timestamp":1660262400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007601","name":"Horizon 2020","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007601","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Late-onset epilepsy (LOE) has recently become a topic of intense research. Besides stroke, tumors, and dementia, autoimmune encephalitis (AE) has emerged as another possible cause of recurrent seizures in the elderly, and may account for a proportion of cases of LOE of unknown origin (LOEUO). This 24-h ambulatory electroencephalography (AEEG)-based study compared patients with LOEUO and AE to identify features suggestive of immune-mediated seizures in the elderly.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>We retrospectively reviewed 232 AEEG examinations performed in patients over 55 years with \u22656-month follow-up, and selected 21 subjects with AE and 25 subjects with LOEUO. Clinical charts and AEEG recordings were carefully analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty-five patients with LOEUO (12 women, mean age at onset 67.9 years) and 21 AE subjects (8 women, mean age at onset 65.7 years) were enrolled. High-frequency seizures were reported in 20\/21 AE and 7\/25 LOEUO cases (<jats:italic>p<\/jats:italic> &amp;lt; 0.00001). Focal aware seizures were more common in AE (14\/21 vs. 6\/25, <jats:italic>p<\/jats:italic> = 0.00058), whereas \u201cisolated\u201d focal-to-bilateral tonic-clonic seizures occurred in 5\/25 patients with LOEUO only (<jats:italic>p<\/jats:italic> = 0.053). AE subjects reported ictal autonomic manifestations more frequently (<jats:italic>p<\/jats:italic> = 0.0033). Three-hundred-seventy and 24 seizures were recorded in 13\/21 patients with AE and 3\/25 patients with LOEUO, respectively (<jats:italic>p<\/jats:italic> = 0.0006). Interictal epileptiform discharges were observed in 70% of both groups, but their sleep activation was more common in AE (<jats:italic>p<\/jats:italic> = 0.06).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our study shows that high-frequency focal seizures with autonomic manifestations should raise the suspicion of AE in the elderly with new-onset seizures. It also highlights the relevant contribution of AEEG, which might reduce the diagnostic delay and provide useful clues to recognize AE.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2022.924859","type":"journal-article","created":{"date-parts":[[2022,8,12]],"date-time":"2022-08-12T06:27:46Z","timestamp":1660285666000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["Late-onset seizures and epilepsy: Electroclinical features suggestive of autoimmune etiology"],"prefix":"10.3389","volume":"13","author":[{"given":"Alessandra","family":"Morano","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuele","family":"Cerulli Irelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico 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