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.
