Mechanisms and Emerging Therapies for Treatment of Seizures in Pediatric Autoimmune Encephalitis and Autoinflammatory/Autoimmune-Associated Epilepsy

Emerging knowledge of pathophysiologic mechanisms behind seizure generation has led to increased targeted therapeutics (eg, rituximab, IL-1 and IL-6 inhibitors) in the treatment of acute seizures secondary to autoimmunity or autoinflammation as well as chronic autoimmune/autoinflammatory-associated epilepsies. Those with acute symptomatic seizures as seen in AE and SLE may have the best treatment response, whereas patients with chronic autoimmune/autoinflammatory-associated epilepsies tend to be refractory to multimodal treatment, including immunomodulation. Further research to delineate the most efficacious treatment strategy, as well as how to distinguish these seizures from alternative causes to initiate specific treatment early, is needed.