Antibodies Causing Epilepsy Syndromes: The ACES Study.

Erasmus Medical Center582 enrolled

Overview

The Antibodies Causing Epilepsy Syndromes (ACES) Study is a observational cohort study focusing on detection of auto-immune epilepsy in patients with epilepsy of unknown origin.

Recently new treatable causes of epilepsy have been identified. These disorders are caused by a disruption of the balance in the brain caused by inflammation. This inflammatory reaction is caused by an autologous reaction of the immune system to specific brain proteins. The body produces antibodies to specific parts of the brain. These disorders can lead to epilepsy, memory dysfunction and psychiatric problems. Recognition is necessary for good treatment. Mostly anti-epileptic drugs are insufficient. These diseases can be treated with immune-modulating therapy. The ACES Study will focus on determining the frequencies of known antibodies and finding new, currently unknown, antibodies, causing epilepsy. Therefore patients will be investigated with epilepsy of unknown origin. To find new antibodies sera of patients with epilepsy will be added to brain sections of rats and to cultivated neuronal cells to look for a reaction. If new antibodies will be detected clinical features will be mapped of the patients. Also effects of antibodies on brain cells will be determined. Discovery of new antibodies can provide new treatment options for these patients. Also it will enable to discover more about the pathologic mechanisms of epilepsy.

Study Type

OBSERVATIONAL

Enrollment

582

Conditions

Auto-immune Encephalitis Epilepsy

Interventions

vena punctionBIOLOGICAL

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Age of 18 and older. * Status epilepticus or new onset seizures with signs of limbic encephalitis (clinical picture, MRI (FLAIR abnormalities), EEG abnormalities or CSF findings (CSF pleocytosis, increased IgG index, oligoclonal bands), or: * Patients with acquired chronic focal epilepsy with an unknown cause. Exclusion Criteria: * Children * Epilepsy with known cause

Locations (8)

Epilepsiecentrum Kempenhaeghe

Heemstede, Netherlands

Stichting Epilepsie Instelling Nederland (SEIN)

Heemstede, Netherlands

Academic Hospital Maastricht

Maastricht, Netherlands

Erasmus Medisch Centrum

Rotterdam, Netherlands

Outcomes

Primary Outcomes

frequency of patients with known and novel antibodies

detection of specific known and novel, currently unknown, auto-antibodies by immunohistochemistry, live hippocampal neuron cultures and cell-based assay

Time frame: 3 year

Secondary Outcomes

modified Rankin scale

outcome 1 year after inclusion in the study

Time frame: 1 year

Seizure frequency

seizure frequency 1 year after inclusion in the study

Time frame: 1 year

Treatment response

frequency of objective improvement of outcome (seizure frequency, modified Rankin Scale) after immunotherapy, as compared to matched controls (without antibodies) from our study to exclude an effect due to regression to the mean or natural nistory.

Time frame: 3 months

Data from ClinicalTrials.gov

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