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Seizures in autoimmune encephalitis: Kindling the fire
Epilepsia ( IF 5.6 ) Pub Date : 2020-05-13 , DOI: 10.1111/epi.16515
Robb Wesselingh 1, 2 , Helmut Butzkueven 1, 2 , Katherine Buzzard 3, 4 , David Tarlinton 5 , Terence J O'Brien 1, 2 , Mastura Monif 1, 2, 3
Affiliation  

Epilepsy is a common neurological disorder that increases the risk of morbidity and mortality. Autoimmune epilepsy is a subset of epilepsy that occurs in the setting of autoimmunity, such as in autoimmune encephalitis (AIE). AIE is an autoimmune disorder characterized by immune‐mediated neuroinflammation resulting in a variety of neurological symptoms, including psychiatric disturbance, cognitive dysfunction, and seizures. Seizures in AIE are thought to be a result of antibodies directed against neuronal cell‐surface proteins involved in synaptic transmission. The role of blood‐brain barrier dysfunction, myeloid cell infiltration, and the initiation of proinflammatory cascades in epileptogenesis has been shown to be important in animal models and human patients with epilepsy. Epileptogenesis in AIE is likely to arise from the synergistic effect of both innately driven neuroinflammation and antibody‐induced hyperexcitability. Together, these processes produce persistent drug‐resistant seizures that contribute to the morbidity seen in AIE. Understanding the proinflammatory pathways involved in this process may improve diagnostics and provide alternative treatment targets in AIE.

中文翻译:

自身免疫性脑炎的癫痫发作:引火烧身

癫痫是一种常见的神经系统疾病,会增加发病率和死亡率的风险。自身免疫性癫痫是癫痫的一个子集,发生在自身免疫环境中,例如自身免疫性脑炎 (AIE)。AIE 是一种自身免疫性疾病,其特征是免疫介导的神经炎症,导致多种神经系统症状,包括精神障碍、认知功能障碍和癫痫发作。AIE 的癫痫发作被认为是针对参与突触传递的神经元细胞表面蛋白的抗体的结果。血脑屏障功能障碍、骨髓细胞浸润和促炎级联反应在癫痫发生中的作用已被证明在动物模型和人类癫痫患者中很重要。AIE 的癫痫发生可能源于先天驱动的神经炎症和抗体诱导的过度兴奋的协同作用。总之,这些过程会产生持续的耐药性癫痫发作,从而导致 AIE 的发病率。了解这一过程中涉及的促炎途径可能会改进诊断并提供 AIE 的替代治疗目标。
更新日期:2020-05-13
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