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In a 2018 study, the incidence and prevalence of autoimmune encephalitis were comparable to those of infectious encephalitis ( 11). Autoimmune-associated epilepsy (AE) or autoimmune epilepsy is now recognized as an important etiology in a subset of patients with both acute symptomatic seizures and chronic epilepsy ( 6, 8– 10). This has led to a significant increase in the incidence of identified patients with autoimmune encephalitis and epilepsy ( 7). Over the past two decades, numerous neural auto-antibodies associated with encephalitis, seizures, and epilepsy have been discovered ( 6). The risk of post-encephalitic epilepsy (PE) ranges from 10 to 40% across several studies ( 2– 5). It is associated with a high risk of acute symptomatic seizures, status epilepticus, and remote symptomatic epilepsy ( 2). Prospective studies are warranted to explore the efficacy of KDT in management of patients with PE and AE.Īcute encephalitis is associated with significant morbidity and mortality, with an estimated annual global incidence of 0.07–12.6 cases per 100,000 ( 1). Overall, seven patients (70%) achieved ≥50% seizure reduction.Ĭonclusion: In addition to its established role in the treatment of RSE, KDT may be a safe and feasible option for the treatment of chronic PE and AE, particularly in those with prior history of SE. Three patients (30%) became seizure-free, one patient (10%) achieved 90% seizure freedom, and three patients (30%) achieved a 50–75% reduction in their baseline seizure frequency, while three patients (30%) had no significant benefit. The median duration of MAD was 10 months (IQR: 3.75–36). The median latency between starting MAD and onset of encephalitis was 6 years (IQR: 1–10). Four patients had either confirmed or presumed viral encephalitis, five patients had seronegative AE, and one patient had GAD65 AE. Results: Ten patients with PE and AE who were treated with adjunctive MAD were included.
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Methods: A retrospective single-center case series examining adult patients with PE and AE treated with the modified Atkins diet (MAD), a KDT commonly used by adults with drug-resistant epilepsy. This study aims to investigate the use of KDT in patients with PE and AE. However, the role of KDT in the chronic management of Post-encephalitic epilepsy (PE) and autoimmune-associated epilepsy (AE) is unknown. Ketogenic diet therapies (KDT) have been established as a feasible and safe adjunctive management of refractory- and super-refractory status epilepticus. Introduction: Acute Encephalitis is associated with a high risk of acute symptomatic seizures, status epilepticus, and remote symptomatic epilepsy.