Korff Christian M, Dale Russell C
Pediatric Neurology Unit, University Hospitals of Geneva, Geneva, Switzerland; and
The Children's Hospital at Westmead Clinical School, University of Sydney, Sydney, New South Wales, Australia.
Pediatrics. 2017 Sep;140(3). doi: 10.1542/peds.2016-3534. Epub 2017 Aug 9.
The relation between the immune system and epilepsy has been studied for a long time. Immune activation may precede or follow the appearance of seizures. Depending on the situation, the innate and acquired immunity may be involved to various degrees. The intense, ongoing research has opened encouraging management and therapeutic perspectives for a significant number of patients suffering from seizures. These include the use of various drugs and less conventional approaches with anti-inflammatory or immunomodulatory properties. Data for children remain scarce, however, and the practical implications of recent discoveries in the field remain to be identified formally. The aim of this review is to present current knowledge of the role of immunity in relation to seizures, with a particular emphasis on clinical data available in childhood. More specifically, various autoantibodies involved in autoimmune encephalitis and epilepsy and general pathophysiological hypotheses on the role of immunity in seizure genesis are discussed, specific epilepsy syndromes in which autoimmune components have been studied are summarized, workup recommendations and therapeutic options are suggested, and finally, open questions and future needs are presented.
免疫系统与癫痫之间的关系已被研究了很长时间。免疫激活可能先于或后于癫痫发作的出现。根据具体情况，先天性免疫和获得性免疫可能会不同程度地参与其中。深入且持续的研究为大量癫痫患者开辟了令人鼓舞的治疗和管理前景。这些包括使用各种具有抗炎或免疫调节特性的药物以及不太传统的方法。然而，儿童方面的数据仍然匮乏，该领域近期发现的实际意义仍有待正式确定。本综述的目的是介绍目前关于免疫在癫痫发作中作用的知识，特别强调儿童期可用的临床数据。更具体地说，讨论了自身免疫性脑炎和癫痫中涉及的各种自身抗体以及关于免疫在癫痫发作发生中作用的一般病理生理假设，总结了已研究过自身免疫成分的特定癫痫综合征，提出了检查建议和治疗选择，最后，提出了未解决的问题和未来需求。
