Autoimmune Epilepsy

سال انتشار: 1398
نوع سند: مقاله کنفرانسی
زبان: انگلیسی
مشاهده: 379

نسخه کامل این مقاله ارائه نشده است و در دسترس نمی باشد

استخراج به نرم افزارهای پژوهشی:

لینک ثابت به این مقاله:

شناسه ملی سند علمی:

EPILEPSEMED16_073

تاریخ نمایه سازی: 28 بهمن 1398

چکیده مقاله:

Autoimmune epilepsy has been one of the fastest growing topics in the last few decades after the discovery of neural autoantibodies. Autoimmune epilepsy is characterized by new-onset refractory seizures along with subacute progressive cognitive decline, behavioral and psychiatric dysfunction. Neural specific antibodies are commonly associated with autoimmune epilepsy including autoantibodies against neuronal intracellular (ANNA-1, CRMP-5, GAD65, Ma/Ta) or surface cell (NMDAR, LGI-1, AMPAR, GABAR, CASPR2, DPPX) proteins. An autoimmune mediated epilepsy is suspected when medically intractable seizures encountered in the presence of at least one neural antibody, and inflammatory changes found in CSF or MRI or presence of family history of autoimmune disease. Predictive models (Antibody Prevalence in Epilepsy and Encephalopathy [APE2] and Response to Immunotherapy in Epilepsy and Encephalopathy [RITE2] scores) consisting clinical features and initial neurological assessment could be utilized for cases selection, evaluation and management in autoimmune epilepsy. Currently there is no level one data regarding the treatment of autoimmune epilepsy from randomized controlled trials. Practically, first line of treatment is intravenous methylprednisolone (1g/day for 3 to 5 days) and/or intravenous immunoglobulin (IVIG) (0.4 g/kg/day for 3-5 days). If no response is observed it is essential to try the second line immunosuppressant, Rituximab or Cyclophosphamide. It is certain that early diagnosis and appropriate treatment could improve the clinical course and the prognosis in these patients.

نویسندگان

Behnam Safarpour Lima

Neurologist/Epileptologist Assistant Professor of Shahid Beheshti University of Medical Sciences