Peltola J T, Haapala A, Isojärvi J I, Auvinen A, Palmio J, Latvala K, Kulmala P, Laine S, Vaarala O, Keränen T
Department of Neurology, Tampere University Hospital, Tampere, Finland.
Am J Med. 2000 Dec 15;109(9):712-7. doi: 10.1016/s0002-9343(00)00617-3.
The increased prevalence of autoantibodies in patients with epilepsy has been traditionally regarded to be a consequence of antiepileptic drugs. The purpose of this study was to measure autoantibodies in well-defined groups of patients with seizures to determine the effects of epilepsy and antiepileptic medications on the presence of autoantibodies.
We studied the frequency of antinuclear antibodies, anti-beta2-glycoprotein I antibodies, and anticardiolipin antibodies in 50 patients with therapy-resistant localization-related epilepsy, 50 patients with generalized epilepsy syndromes, 52 patients with a newly diagnosed seizure disorder but no antiepileptic medication, and 83 healthy controls.
Compared with controls, newly diagnosed patients had a significantly greater prevalence of immunoglobulin (Ig) G class anticardiolipin antibodies (21% versus 7%); the prevalence was 14% in patients with localization-related epilepsy and 8% in patients with generalized epilepsy. The prevalence of IgM class anticardiolipin antibodies was significantly greater in all seizure groups (60% in localization-related epilepsy, 42% in generalized epilepsies, and 33% in newly diagnosed patients) compared with controls (7%). Antinuclear antibodies were significantly more common in newly diagnosed patients (21%) and localization-related epilepsy (24%) compared with controls (12%). When patients with generalized epilepsy (8%) were used as the reference group, antinuclear antibodies were also significantly more frequent in localization-related epilepsy (relative risk [RR] = 2.9, 95% confidence interval [CI]: 1.1 to 8.2) and newly diagnosed seizures (RR = 3.4, 95% CI: 1.2 to 9.3). There were no consistent associations between autoantibodies and specific antiepileptic medications.
The prevalence of autoantibodies is greater in patients with epilepsy, including newly diagnosed seizure disorder. The increased prevalence of autoantibodies is more strongly associated with epilepsy than with antiepileptic drugs, perhaps indicating that immune dysregulation may be commonly associated with epilepsy.
癫痫患者自身抗体患病率增加传统上被认为是抗癫痫药物的结果。本研究的目的是测量明确的癫痫发作患者组中的自身抗体，以确定癫痫和抗癫痫药物对自身抗体存在的影响。
我们研究了50例治疗抵抗性局灶性相关性癫痫患者、50例全身性癫痫综合征患者、52例新诊断的癫痫发作障碍但未服用抗癫痫药物的患者以及83名健康对照者中抗核抗体、抗β2糖蛋白I抗体和抗心磷脂抗体的频率。
与对照组相比，新诊断患者中免疫球蛋白（Ig）G类抗心磷脂抗体的患病率显著更高（21%对7%）；局灶性相关性癫痫患者中的患病率为14%，全身性癫痫患者中的患病率为8%。与对照组（7%）相比，所有癫痫发作组中IgM类抗心磷脂抗体的患病率显著更高（局灶性相关性癫痫中为60%，全身性癫痫中为42%，新诊断患者中为33%）。与对照组（12%）相比，抗核抗体在新诊断患者（21%）和局灶性相关性癫痫（24%）中明显更常见。以全身性癫痫患者（8%）作为参照组时，抗核抗体在局灶性相关性癫痫（相对风险[RR]=2.9，95%置信区间[CI]：1.1至8.2）和新诊断的癫痫发作（RR=3.4，95%CI：1.2至9.3）中也明显更频繁。自身抗体与特定抗癫痫药物之间没有一致的关联。
癫痫患者，包括新诊断的癫痫发作障碍患者，自身抗体的患病率更高。自身抗体患病率的增加与癫痫的关联比与抗癫痫药物的关联更强，这可能表明免疫失调可能通常与癫痫相关。
