2025 American Academy of Neurology Abstract Website

Objective:

This systematic review and meta-analysis aimed to assess the impact of antiphospholipid antibodies on the prevalence and severity of epilepsy. Two specific comparisons were analyzed: (1) healthy individuals versus aPL-positive epileptic patients and (2) aPL-positive epileptic patients versus aPL-negative epileptic patients.

Background:

The relationship between antiphospholipid antibodies (aPL) and epilepsy has been a topic of growing interest. Antiphospholipid syndrome (APS) is known to influence various neurological conditions. However, the precise impact of aPL antibodies on epilepsy remains unclear, particularly when comparing healthy individuals to epileptic patients and epileptic patients with and without aPL antibodies. Studies have shown varying outcomes regarding the role of aPL antibodies in the severity and prevalence of epilepsy.

Design/Methods:

This meta-analysis followed PRISMA guidelines and with a PROSPERO registration number CRD42024580878. Systematic searches were conducted in PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), and Embase for relevant control tirals, cohort and case-control studies published up to June 2024.

Results:

The analysis included 3,083 patients. The prevalence of aPL antibodies was statistically significant, being higher in epileptic patients compared to healthy controls (RR = 2.69, 95% CI = [1.47, 4.92], p = 0.001). In terms of epilepsy subtypes, the prevalence of aPL antibodies showed a trend favoring partial epilepsy (OR = 0.72, 95% CI = [0.32, 1.58], p = 0.41), although this was not statistically significant. For those with generalized epilepsy, the prevalence remained non-significant as well (OR = 1.13, 95% CI = [0.69, 1.85], p = 0.63).

Conclusions:

Our investigation reveals a significant correlation between the presence of aPL antibodies and epilepsy, indicating that aPL antibodies are more prevalent in epileptic patients. While there was a trend in partial epilepsy, it did not reach statistical significance, nor did generalized epilepsy. These outcomes underline the necessity for further research to understand the implications of aPL in different types of epilepsy.