Long-Term Seizure Outcomes and Epilepsy Risk in Anti-LGI1 Encephalitis: Insights from a Multicenter Cohort Study

Highlight

• Anti-LGI1 encephalitis patients rarely develop chronic autoimmune epilepsy (5.9%), with most achieving sustained seizure remission after immunotherapy.
• Longer time to seizure remission and presence of pilomotor seizures are associated with delayed seizure control and persistent cognitive impairment.
• Immunotherapy, especially second-line treatments, significantly increases the rate of seizure remission over time.
• The study supports reclassifying seizures after remission as acute symptomatic rather than chronic epilepsy due to relatively low seizure recurrence risk.

Study Background