Over the last 10 to 15 years, there has been increasing recognition that autoimmune or inflammatory conditions can cause epilepsy. When this is the underlying cause, treatment requires targeted immune therapy, in addition to anti-seizure medications. When this is a suspected by a neurologist, the diagnostic work-up may include some additional testing. The approach may be different for each patient and requires a discussion regarding the possible risks and benefits of additional testing or specific treatments.

Characteristics that Raise Concern for Autoimmune Epilepsy

  • Preceding illness or infection
  • Abrupt onset, explosive onset
  • Associated cognitive or mood symptoms
  • Lack of response to anti-seizure medications
  • Personal or family history of autoimmune disease
  • Risk factors for cancer (smoking, personal history, unexplained weight loss, etc.)
  • Status epilepticus of unknown cause

What Information Do These Tests Reveal?

  • Long-term EEG: evaluates for high number of seizures or multiple areas of the brain from which seizures arise.
  • Special blood work: tests for the presence of antibodies known to be associated with autoimmune epilepsy.
  • Spinal tap: tests the cerebral spinal fluid which surrounds the brain. This may be a more specific marker for inflammation or irritation, and antibodies can be tested for in the spinal fluid.
  • CT or PET scan of the entire body: searches for possible small, undiagnosed cancers, which may be the trigger for autoimmune epilepsy.
  • PET scan of the brain: looks as brain metabolism, which may be specially altered with autoimmune epilepsy.
Authored By: 
Amy Z. Crepeau MD
Authored Date: 
Reviewed By: 
Joseph I. Sirven MD
Wednesday, August 24, 2016