Antibodies Causing Epilepsy Syndromes: The ACES Study.

Study Overview
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Brief Summary
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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.

Detailed Description
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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.

Official Title
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Antibodies Causing Epilepsy Syndromes: The ACES Study.

Conditions
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Auto-immune Encephalitis, Epilepsy

Intervention / Treatment
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* Biological: vena punction


Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| acquired chronic, focal, epilepsy<br>patients ≥18 years of age, with acquired chronic epilepsy of unknown origin | Biological: vena punction<br> <br> |
| new onset epilepsy<br>patients ≥18 years of age, with new onset status epilepticus or new onset seizures with suspicion of limbic encephalitis | Biological: vena punction<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 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 | 3 year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| modified Rankin scale | outcome 1 year after inclusion in the study | 1 year | 
| Seizure frequency | seizure frequency 1 year after inclusion in the study | 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. | 3 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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antibodies, auto-immune encephalitis, epilepsy, limbic encephalitis