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自身免疫性运动障碍:临床与实验室方法。

Autoimmune Movement Disorders: a Clinical and Laboratory Approach.

机构信息

Department of Laboratory Medicine and Pathology, College of Medicine, Mayo Clinic, Rochester, MN, USA.

Department of Neurology, College of Medicine, Mayo Clinic, Rochester, MN, USA.

出版信息

Curr Neurol Neurosci Rep. 2017 Jan;17(1):4. doi: 10.1007/s11910-017-0709-2.

Abstract

Autoimmune movement disorders are caused by an aberrant immune response to neural self-antigens. These disorders may be paraneoplastic, parainfectious, or (most commonly) idiopathic. The neurological presentations are diverse, and sometimes multifocal. Movement disorders can occur as part of the spectrum with phenotypes including chorea, myoclonus, ataxia, CNS hyperexcitability (including stiff-person syndrome), dystonia, and parkinsonism. Symptoms are subacute in onset and may have a fluctuating course. The best characterized disorders are unified by neural autoantibodies identified in serum or cerebrospinal fluid. The antibody specificity may predict the association with cancer and the response to immunotherapy. In this article, we review autoimmune-mediated movement disorders, associated cancers, diagnosis, and treatment.

摘要

自身免疫性运动障碍是由针对神经自身抗原的异常免疫反应引起的。这些疾病可能是副肿瘤性的、副感染性的,或者(最常见的)特发性的。神经学表现多种多样,有时呈多灶性。运动障碍可能是一种表型的一部分,包括舞蹈症、肌阵挛、共济失调、中枢神经系统兴奋性过高(包括僵人综合征)、肌张力障碍和帕金森病。症状呈亚急性起病,且可能具有波动性病程。最具特征性的疾病是通过在血清或脑脊液中发现神经自身抗体来确定的。抗体特异性可能预测与癌症的关联以及对免疫治疗的反应。在本文中,我们综述了自身免疫介导的运动障碍、相关癌症、诊断和治疗。

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