Seizures and Convulsions
Autoimmune factors may play a bigger role in seizure disorders than previously suspected. In fact, a growing number of autoantibodies are being linked with idiopathic seizures.

Seizures and Convulsions
Seizures occur when there is a sudden, uncontrolled electrical disturbance in the brain. An imbalance in neurotransmitter signaling causes neurons to become overexcited, inducing abnormal bursts of electrical activity in the brain.¹ This, in turn, can cause a range of mild to severe symptoms including uncontrolled muscle spasms, confusion, staring spells, cognitive impairment and loss of consciousness. Often, the terms “convulsions” and “seizures” are used interchangeably.
Epilepsy is a neurologic disorder that causes recurrent seizures. However, not everyone who has seizures has epilepsy. It can be difficult to identify the exact cause of seizures in adults with no prior history. In fact, for 1 in 3 adults with epilepsy, there is no known cause. But now, studies indicate that “an autoimmune cause appears to be the potential culprit in at least 20% of [those] cases.” 2

Autoimmune-induced seizures in adults with no history

Seizures in adults with no seizure history can be caused by a number of factors ranging from high blood pressure, drug abuse and toxic exposures to brain injury, brain infection (encephalitis) and heart disease. Mounting evidence also indicates that an immune dysfunction or abnormal autoimmune activity can elicit a sudden onset of seizures in adults with no history of the illness. 2

Seizures in adults with no seizure history can be caused by a number of factors ranging from high blood pressure, drug abuse and toxic exposures to brain injury, brain infection (encephalitis) and heart disease.

Immune dysfunction or abnormal autoimmune activity can elicit a sudden onset of seizures in adults with no history of the illness. 2

It’s well-established that people with certain autoimmune disorders, such as lupus, type 1 diabetes, celiac disease, multiple sclerosis, rheumatoid arthritis, and psoriasis, are at greater risk of developing epileptic seizures. Studies put the risk as high as 4-fold in adults and 5-fold in children.³ According to researchers, “Immune dysfunction may be partly responsible for this association.” 4

Get treated for treatment-resistant symptoms

Investigators from Mayo Clinic point out, “It’s now a recognized and accepted fact that a proportion of patients with new-onset epilepsy can have an autoimmune etiology.” 5 Individuals with autoimmune-induced seizures typically do not respond to traditional seizure medications and treatments, and are often classified as having drug resistant epilepsy. 5

“It’s now a recognized and accepted fact that a proportion of patients with new-onset epilepsy can have an autoimmune etiology,” according to investigators from Mayo Clinic. 5

Individuals with autoimmune-induced seizures typically do not respond to traditional seizure medications and treatments, and are often classified as having drug resistant epilepsy. 5

Others agree. Autoimmune factors may play a role in the onset of seizures in adults with no history and who do not respond to standard medication. “Accumulating evidence supports the role of autoimmune-mediated factors in patients with AED [antiepileptic drug]-resistant seizures.” 6

Identifying whether an autoimmune condition is causing the seizures or drug resistant epilepsy is important since treatment with immunotherapies can dramatically impact chances of recovery. 7 In fact, one study found 81% of patients had “significant improvement in seizure status” and 67% achieved “seizure freedom, a majority of whom were antiepileptic drug [AED] resistant.” 7

Identifying whether an autoimmune condition is causing the seizures or drug resistant epilepsy is important since treatment with immunotherapies can dramatically impact chances of recovery. 7

One study found 81% of patients had “significant improvement in seizure status” and 67% achieved “seizure freedom, a majority of whom were antiepileptic drug [AED] resistant.” 7

Autoantibodies, encephalitis and seizures

A growing number of autoantibodies are being identified and linked with seizures that have no known cause. “Specific autoimmune causes, typically associated with autoantibodies, have been increasingly identified in a subset of previously idiopathic seizure disorders.” 8

Others report, “it is widely believed that antibodies targeting against intracellular antigens or neuronal surface antigens are the potential causes [of idiopathic seizures].” 6

Several studies report the presence of specific neural autoantibodies in patients with autoimmune epilepsy, including antibodies against the NMDA receptor, AMPA receptors, LGI1 protein, and GABAb receptor.

However, not all autoimmune antibodies have yet been identified. Some individuals may have autoimmune-induced seizures “even without underlying antibody positivity, which may reflect the yet undiscovered array of neuronal antibodies that could result in autoimmune epilepsy.” 9

In some cases, autoimmune seizures may be the result of an infection-triggered autoimmune encephalopathy/encephalitis. This occurs when the immune system produces antibodies meant to destroy a foreign substance (i.e. bacteria, virus) but instead mistakenly attack healthy tissue in the brain (autoantibodies), causing inflammation (encephalitis) and the onset of seizures in children and adults with no history of epilepsy.

In some cases, seizures may be due to an infection-triggered autoimmune encephalitis.

This occurs when the immune system produces antibodies meant to destroy a foreign substance (i.e. bacteria, virus) but instead mistakenly attack healthy tissue in the brain (autoantibodies), causing inflammation (encephalitis) and the onset of seizures in children and adults with no history of epilepsy.

How can infections trigger an autoimmune reaction and the onset of seizures?

“Certain infections are known to trigger encephalitis (brain inflammation) and epilepsy in children,” states Korff and Dale. 10

“Some of them directly infect the brain and cause a primary viral encephalitis; on the other hand, certain micro-organisms can induce a secondary autoimmune encephalitis.” For instance, herpes simplex and mycoplasma have the highest potential to result in ongoing epilepsy. 10

Cunningham Panel™ identifies autoimmune seizures

Researchers describe the case of a 15-year-old girl, who developed a sudden onset of neuropsychiatric symptoms along with “seizure-like” episodes. The patient’s anti-NMDAR antibody test was negative and MRI’s were normal. However, her Cunningham Panel™ test results were positive, which indicated that her symptoms, including the seizures, were likely caused by an autoimmune reaction, triggered by an infection(s).

The girl was treated with immunotherapy, including plasma exchange. After 2 weeks of treatment, her symptoms had completely resolved. 11

  1. Stephen, L.J., Brodie, M.J. Pharmacotherapy of Epilepsy. CNS Drugs 25, 89–107 (2011). https://www.ncbi.nlm.nih.gov/pubmed/21254787
  2. Dubey D, Alqallaf A, Hays R, et al. Neurological autoantibody prevalence in epilepsy of unknown etiology. JAMA Neurol. 2017 https://jamanetwork.com/journals/jamaneurology/fullarticle/2599939
  3. Ong M, Kohane IS, Cai T, Gorman MP, Mandl KD. Population-Level Evidence for an Autoimmune Etiology of Epilepsy. JAMA Neurol. 2014;71(5):569–574. doi:10.1001/jamaneurol.2014.188 https://jamanetwork.com/journals/jamaneurology/fullarticle/1851479
  4. Amanat, Man et al. Seizures as a clinical manifestation in somatic autoimmune disorders. Seizure - European Journal of Epilepsy, Volume 64, 59 - 64 https://www.seizure-journal.com/article/S1059-1311(18)30589-2/fulltext
  5. MedPage Today. Nyberg. Identification and Treatment of Autoimmune Epilepsy. July 13, 2018. https://www.medpagetoday.com/resource-centers/contemporary-advances-epilepsy/identification-and-treatment-autoimmune-epilepsy/2088
  6. Fang Z, Yang Y, Chen X, et al. Advances in Autoimmune Epilepsy Associated with Antibodies, Their Potential Pathogenic Molecular Mechanisms, and Current Recommended Immunotherapies. Front Immunol. 2017;8:395. Published 2017 Apr 25. doi:10.3389/fimmu.2017.00395 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5403900/
  7. Quek AM, Britton JW, McKeon A, et al. Autoimmune epilepsy: clinical characteristics and response to immunotherapy. Arch Neurol. 2012;69(5):582–593. doi:10.1001/archneurol.2011.2985 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3601373/
  8. Ong MS, Kohane IS, Cai T, Gorman MP, Mandl KD. Population-level evidence for an autoimmune etiology of epilepsy. JAMA Neurol. 2014;71(5):569–574. doi:10.1001/jamaneurol.2014.188 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4324719/
  9. Dubey, Divyanshu et al. Retrospective case series of the clinical features, management and outcomes of patients with autoimmune epilepsy. Seizure - European Journal of Epilepsy, Volume 29, 143-147 https://www.ncbi.nlm.nih.gov/pubmed/26076858
  10. Christian M. Korff, Russell C. Dale. The Immune System in Pediatric Seizures and Epilepsies. Pediatrics Sep 2017, 140 (3) e20163534; DOI: 10.1542/peds.2016-3534 https://pediatrics.aappublications.org/content/140/3/e20163534
  11. Barzman DH, Jackson H, Singh U, Griffey M, Sorter M, Bernstein JA. An Atypical Presentation of Pediatric Acute Neuropsychiatric Syndrome Responding to Plasmapheresis Treatment. Case Rep Psychiatry. 2018;2018:8189067. Published 2018 Jun 28. doi:10.1155/2018/8189067 https://www.ncbi.nlm.nih.gov/pubmed/30050718
sudden onset of seizures in adults

Mounting evidence indicates that abnormal autoimmune activity can elicit a sudden onset of seizures in adults.

In some cases, infections trigger an autoimmune reaction that may result in seizures in adults with no history
How can an infection cause seizures in adults with no history?

Learn more about how infections can trigger neuropsychiatric symptoms

Cunningham Panel helps identify seizures in adults with no history

Cunningham Panel™ helps identify an autoimmune disorder in child initially diagnosed with schizophrenia

Researchers describe a complex case involving a 15-year-old girl, who abruptly developed multiple neurologic and psychiatric symptoms.

The association between streptococcus pyogenes and tics/OCD

The association between streptococcus pyogenes and tics/OCD

In this book chapter, Dr. Madeleine Cunningham explains the association between Group A strep and the onset of tics and/or OCD and their clinical manifestations in children with the autoimmune neuropsychiatric disorder, PANDAS.

Childhood infections can increase risk of mental illness in kidss

Childhood infections can increase risk of mental illness in kids

Nationwide study finds both mild and severe infections can increase risk of mental disorders in children and adolescents..

  • Test Order Process
    The Cunningham Panel™ – Antibody testing that helps determine whether an autoimmune response may be triggering neurologic and/or psychiatric symptoms.

B. Robert Mozayeni, MD

Medical and Clinical Advisor

B. Robert Mozayeni MD

Dr. B. Robert Mozayeni was trained in Internal Medicine and Rheumatology at Yale and at NIH. He has had pre- and post-doctoral Fellowships in Molecular Biophysics and Biochemistry at Yale, and also at NIH where he was a Howard Hughes Research Scholar at LMB/DCBD/NCI and later, Senior Staff Fellow at LMMB/NHLBI/NIH. Editorial board of Infectious Diseases – Surveillance, Prevention and Treatment. Past President of the International Lyme and Associated Diseases Society (ILADS).

He is an expert in Translational Medicine, the science and art of advancing medical science safely and efficiently. He is a Fellow of the non-profit Think Lead Innovate Foundation and is a co-founder of the Foundation for the Study of Inflammatory Diseases. He is a Founder of the Foundation for the Study of Inflammatory Diseases to crowd-source medical solutions for complex conditions using existing knowledge, diagnostic methods, and therapies to meet patient needs immediately. He is the Chief Medical Officer of Galaxy Diagnostics, LLC. He is a Board member of the Human-Kind Alliance. Dr. Mozayeni has held admitting privileges (since 1994) on the clinical staff of Suburban Hospital, a member of Johns Hopkins Medicine and an affiliate of the National Institutes of Health Clinical Center.

Safedin Sajo Beqaj, PhD, HCLD, CC (ABB)

Moleculera Labs, Clinical Laboratory Advisor
Medical Database, Inc., President and CEO

Sajo Baqaj, PhD

Dr. Sajo Beqaj is board certified in molecular pathology and genetics and licensed as a Bioanalyst and High Complexity Laboratory Director. He has been practicing as a laboratory director since 2005.

Dr. Beqaj served as a technical director and was part of the initial management team for several well-known laboratories in the clinical lab industry including PathGroup, Nashville, TN; DCL Medical Laboratories, Indianapolis, IN, and Pathology, Inc, Torrance, CA. He is currently serving as off-side CLIA laboratory director for BioCorp Clinical Laboratory, Whittier, CA and Health360 Labs, Garden Grove, CA.

Dr. Beqaj received his Ph.D. in Pathology from Wayne State University Medical School, Detroit, Michigan. He performed his post-doctoral fellowship at Abbott Laboratories from 2001-2003 and with Children’s Hospital and Northwestern University from 2003-2005.

Dr. Beqaj has taught in several academic institutions and has published numerous medical textbook chapters and journal articles. He has served as a principal investigator in clinical trials for several well-known pharmaceutical and diagnostic companies such as Roche HPV Athena, Merck HPV vaccine, BD vaginitis panel, Roche (Vantana) CINtec® Histology clinical trials, and has presented various scientific clinical abstracts and presentations.

He is a member of several medical and scientific associations including the Association of Molecular Pathology, American Association of Clinical Chemistry and the Pan Am Society for Clinical Virology. He has served on a number of clinical laboratory regulatory and scientific committees, and has assisted several laboratories and physicians as a Clinical Laboratory Consultant.

Rodney Cotton, MBA

Moleculera Labs Board Member

Rodney Cotton, MBA

Rodney Cotton, MBA is an entrepreneurial thought leader in the pharmaceutical/biotech industry who is known for his holistic perspective, bias for action in the face of challenges, and commitment to agile processes.

Rod is an independent director for Orchard Software, a private equity-backed health technology company owned by Francisco Partners; an advisory board member to Flo2 Ventures, a venture capital-backed healthcare and health equity accelerator; and a member of the board of directors and three board committees (Audit, Compliance & Finance; Governance & Equity; and Quality of Care) for Community Health Network.

He built a successful career at Roche spanning more than two decades and culminating in the role of SVP, Head of Strategy & Transformation, and Chief of Staff to the CEO for Roche Diagnostics, the North American headquarters of the world’s largest ($17B) diagnostics company.

While at Roche, Rod led key enterprise initiatives, such as milestone corporate communications, health equity coalitions, the US/Roche Group audit, and global/US acquisition integrations. With 40+ years of experience, he drove the financial turnaround and cultural transformation of four global healthcare companies, led teams of up to 280 total reports, managed P&L of more than $1 billion, and served as a key member of the senior leadership team executing the most significant restructuring of the company in two decades.

In the face of the COVID-19 pandemic, Rod and his team at Roche accelerated six ground breaking products in 11 months, including the first launch of the market’s most accurate and in demand molecular diagnostic test. He also solved extraordinary challenges of product scarcity, supply chain, product allocation, and logistics to achieve accelerated global sourcing and self manufacturing in line with testing guidelines.

A frequent public speaker on health equity and other topics, Rod was named one of the Most Influential Black Executives in Corporate America by Savoy Magazine and one of the Top Blacks in Healthcare by BlackDoctor.org. He also received The Sagamore of the Wabash Award, one of the highest Indiana State honors, bestowed by Indiana Governor Eric J. Holcomb.

Rod holds an M.B.A. from California State University, Dominguez Hills, an M.S. in Strategic Management from the University of Southern California, and a B.A. in Biological Sciences & Technology from the University of California at Santa Barbara.