BACKGROUND We identified seizure characteristics, long-term outcome, and predictors of persistent seizures in children with anti-N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis. METHOD Data from patients with anti-NMDAR encephalitis who presented with seizures at our center between August 2012 and June 2018 were analyzed. RESULTS Sixty-two of 86 patients with anti-NMDAR encephalitis experienced seizures. Seizures occurred within two weeks of disease onset in 58 of 62 (93.6%) patients; 36 of 62 (58.1%) had seizures as the initial symptom. Males were more likely to exhibit seizures as the initial symptom (P = 0.039). More than a quarter of patients (17 of 62, 27.4%) manifested two or more seizure types. Focal seizures were the most common (46 of 62, 74.2%). Status epilepticus occurred in 27 of 62 (43.5%) patients, and nonconvulsive status epilepticus, in two of 62 (3.2%) patients. No patient developed refractory status epilepticus. No systemic tumors were found. Electroencephalographic abnormalities included background slowing (77.4%), absence of a posterior dominant rhythm (62.9%), interictal epileptic discharges (50.0%), and extreme delta brush (6.5%). In the acute phase, 45 patients (45 of 62, 72.6%) received antiepileptic drugs. Persistent seizures occurred in only five of 62 (8%) patients. On univariate analysis, status epilepticus and combination antiepileptic drug treatment were associated with persistent seizures, but neither independently predicted persistent seizures. CONCLUSIONS Multiple seizure types may develop at any stage of anti-N-methyl-d-aspartate receptor encephalitis. Refractory status epilepticus, systemic tumors, and extreme delta brush in electroencephalography are rare in pediatric patients. Anti-NMDAR encephalitis-associated seizures appear to have good prognosis, without the need for long-term antiepileptic drug treatment.

中文翻译：

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小儿抗N-甲基-d-天冬氨酸受体脑炎的癫痫发作特征，结果和癫痫风险。

背景我们确定了抗N-甲基-d-天冬氨酸受体（抗NMDAR）脑炎患儿的癫痫发作特征，长期结局和持续发作的预测因素。方法分析了2012年8月至2018年6月在我们中心发作的抗NMDAR脑炎患者的数据。结果86例抗NMDAR脑炎患者中有62例发生癫痫发作。62例患者中有58例（93.6％）在发病后两周内发作。62例中有36例（58.1％）患有癫痫发作为最初症状。男性更容易出现癫痫发作作为初始症状（P = 0.039）。超过四分之一的患者（62名中的17名，占27.4％）表现出两种或多种癫痫发作类型。局部癫痫发作最常见（62例中占46例，占74.2％）。62例（43.5％）患者中发生了癫痫持续状态，和非惊厥性癫痫持续状态，在62名患者中有2名（3.2％）。没有患者发展为难治性癫痫持续状态。未发现全身性肿瘤。脑电图异常包括背景减慢（77.4％），无后显性节律（62.9％），发作间期癫痫放电（50.0％）和极端三角刷（6.5％）。在急性期，有45名患者（62名中的45名，占72.6％）接受了抗癫痫药治疗。持续性癫痫发作仅发生在62名患者中的5名（8％）中。单因素分析表明，癫痫持续状态和抗癫痫药物联合治疗与持续性癫痫发作有关，但均未独立预测持续性癫痫发作。结论抗-N-甲基-d-天冬氨酸受体脑炎的任何阶段均可出现多种癫痫发作类型。难治性癫痫持续状态，全身性肿瘤，脑电图中的极小三角刷和极小三角刷在儿科患者中很少见。与NMDAR脑炎相关的癫痫发作似乎具有良好的预后，不需要长期的抗癫痫药治疗。