Importance The literature on neural autoantibody positivity in epilepsy has expanded over the last decade, with an increased interest among clinicians in identifying potentially treatable causes of otherwise refractory seizures. Observations Prior studies have reported a wide range of neural autoantibody positivity rates among various epilepsy populations, with the highest frequency reported in individuals with focal epilepsy of unknown cause and new-onset seizures. The antibodies in some cases are of uncertain significance, and their presence can cause conundrums regarding therapy. Conclusions and Relevance There is likely some role for neural autoantibody assessment in patients with unexplained epilepsy who lack clear evidence of autoimmune encephalitis, but the clinical implications of such testing remain unclear owing to limitations in previous published studies. A framework for study design to bridge the current gaps in knowledge on autoimmune-associated epilepsy is proposed.

中文翻译：

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辨别自身免疫和自身抗体在癫痫中的作用：综述。

重要性 关于癫痫中神经自身抗体阳性的文献在过去十年中不断扩大，临床医生对确定其他难治性癫痫发作的潜在可治疗原因的兴趣增加。观察 先前的研究报告了各种癫痫人群中广泛的神经自身抗体阳性率，其中在原因不明的局灶性癫痫和新发癫痫发作的个体中报告的频率最高。在某些情况下，抗体的意义不确定，它们的存在可能会导致治疗上的难题。结论和相关性 对于缺乏明确自身免疫性脑炎证据的不明原因癫痫患者，神经自身抗体评估可能有一定作用，但由于先前发表的研究的局限性，这种测试的临床意义仍不清楚。提出了一个研究设计框架，以弥合当前在自身免疫相关癫痫方面的知识空白。