Costa Fernandes João, Gama Marques João
Clínica Universitária de Psiquiatria e Psicologia Médica, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal.
Clínica de Psiquiatria Geral e Transcultural, Hospital Júlio de Matos, Centro Hospitalar Psiquiátrico de Lisboa, Lisboa, Portugal.
CNS Spectr. 2022 Apr;27(2):191-198. doi: 10.1017/S1092852920001960. Epub 2020 Oct 30.
The term limbic encephalitis has been used with an oncological precedent for over 50 years and, since then, has been applied in relation to multiple antibodies found in its etiological process. Over the last decade, the psychiatric community has brought paraneoplastic autoimmune limbic encephalitis (PALE) to a new light, scattering the once known relationships between said screened antibodies responsible for causing limbic encephalitis. Due to the fact that some individuals with this condition have a psychiatric syndrome as an initial manifestation, the aim of this updated scoping review is to reestablish a causal relationship between the onconeuronal autoantibodies, both intracellular and extracellular, possible underlying malignancies and subsequent neuropsychiatric syndrome. In pair with it, there is the idea of sketching a cleaner thorough picture of what poses as psychiatric symptoms as well as possible therapeutics. Even though the always evolving epistemology of the neurosciences achieved a significant unveiling of what includes PALE in its relevant pathological subgroups, the amount of gray literature still is much superior, appealing to a further research with more randomized controlled trials, with larger populations, so that the results corroborate the small amount of data that already exist and posteriorly be applied in the general population.
边缘性脑炎这一术语在肿瘤学领域已有50多年的先例,从那时起,它就被用于与在其病因过程中发现的多种抗体相关的情况。在过去十年中,精神医学界使副肿瘤性自身免疫性边缘性脑炎(PALE)有了新的认识,打乱了曾经已知的导致边缘性脑炎的筛查抗体之间的关系。由于一些患有这种疾病的个体最初表现为精神综合征,本次更新的范围综述的目的是重新建立细胞内和细胞外肿瘤神经元自身抗体、可能的潜在恶性肿瘤与随后的神经精神综合征之间的因果关系。与此同时,还有一个想法是更清晰、全面地描绘出构成精神症状的因素以及可能的治疗方法。尽管神经科学不断发展的认识论在很大程度上揭示了PALE在其相关病理亚组中的情况,但灰色文献的数量仍然多得多,这就需要进行更多的随机对照试验,纳入更多的人群进行进一步研究,以便结果能够证实已有的少量数据,并随后应用于普通人群。