Wu Yating, Liu Aihua
Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2017 Dec 28;42(12):1452-1457. doi: 10.11817/j.issn.1672-7347.2017.12.015.
Epilepsy is a common chronic brain disorder with multiple causes, and now autoimmune factors are believed to be an independent cause for epilepsy. Accumulating data support an autoimmune basis in patients with antiepileptic drug-resistant seizures. Moreover, systemic autoimmune diseases and epilepsy co-occur frequently. Neural specific autoantibodies can also mediate the process of seizures through different pathways. The diagnosis of autoimmune epilepsy is based on frequency of antiepileptic drug-resistant seizures, the presence of neural specific autoantibodies, inflammatory changes in serum or spinal fluid or on magneticresonanceimaging, the change in electroencephalogram, a personal or family history of autoimmunity. Once autoimmune epilepsy is diagnosed, the immunotherapy is required. Early immunotherapy is crucial for improving the prognosis of the patients.
癫痫是一种常见的慢性脑部疾病,病因多样,目前认为自身免疫因素是癫痫的独立病因。越来越多的数据支持抗癫痫药物难治性癫痫患者存在自身免疫基础。此外,系统性自身免疫疾病与癫痫常同时出现。神经特异性自身抗体也可通过不同途径介导癫痫发作过程。自身免疫性癫痫的诊断基于抗癫痫药物难治性癫痫发作的频率、神经特异性自身抗体的存在、血清或脑脊液中的炎症变化或磁共振成像、脑电图的变化、个人或家族自身免疫病史。一旦诊断为自身免疫性癫痫,就需要进行免疫治疗。早期免疫治疗对改善患者预后至关重要。