Table 2

Antibody prevalence in epilepsy and encephalopathy (APE2 score)

Antibody prevalence in epilepsy and encephalopathy (APE2 score)Value
New onset, rapidly progressive mental status changes that developed over 1–6 weeks or new onset seizure activity (within 1 year of evaluation)(+1)
Neuropsychiatric changes; agitation, aggressiveness, emotional lability(+1)
Autonomic dysfunction (sustained atrial tachycardia or bradycardia, orthostatic hypotension (≥20 mm Hg fall in systolic pressure or ≥ 10 mm Hg fall in diastolic pressure within 3 min of quiet standing), hyperhidrosis, persistently labile blood pressure, ventricular tachycardia, cardiac asystole or gastrointestinal dysmotility)(+1)
Viral prodrome (rhinorrhoea, sore throat, low-grade fever) to be scored in the absence of underlying systemic malignancy within 5 years of neurological symptom onset(+2)
Faciobrachial dystonic seizures(+3)
Facial dyskinesias, to be scored in the absence of faciobrachial dystonic seizures(+2)
Seizure refractory to at least to two antiseizure medications(+2)
CSF findings consistent with inflammation (elevated CSF protein >50 mg/dL and/or lymphocytic pleocytosis >5 cells/µL, if the total number of CSF RBC is <1000 cells/µL)(+2)
Brain MRI suggesting encephalitis (T2/FLAIR hyperintensity restricted to one or both medial temporal lobes, or multifocal in grey matter, white matter or both compatible with demyelination or inflammation)(+2)
Systemic cancer diagnosed within 5 years of neurological symptom onset (excluding cutaneous squamous cell carcinoma, basal cell carcinoma, brain tumour, cancer with brain metastasis)(+2)
Total (max: 18)
  • Adapted with permission from Dubey et al.28

  • CSF, cerebrospinal fluid.