Antibody-associated epilepsies: Clinical features, evidence for immunotherapies and future research questions.
Antibody-associated epilepsies: Clinical features, evidence for immunotherapies and future research questions.
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DOI：
10.1016/j.seizure.2016.07.002
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发表时间：
2016-10
影响因子：
3
通讯作者：
Irani, Sarosh R.
中科院分区：
文献类型：
--
作者：
Bakpa, Ochuko D.;Reuber, Markus;Irani, Sarosh R.
关键词：
自身免疫性癫痫领域与一般癫痫学的相关性日益增加。确定的临床特征往往与自身抗体特异性密切相关。这些疾病通常对早期免疫治疗加上快速升级反应良好。随机对照试验正在急切地等待中。癫痫和脑病与抗表面神经元蛋白（LGI1，NMDAR，CASPR2，GABABR和AMPAR）的自身抗体相关的认识越来越多，这意味着癫痫学家越来越多地询问抗体介导的癫痫发生机制以及免疫疗法的使用。本文综述了与自身免疫性癫痫相关的临床和临床旁观察，检查了免疫治疗有效性的现有证据，并为未来的研究提出了癫痫特异性建议。系统性文献检索，对已识别的出版物进行总结和审查。描述自身抗体相关癫痫和治疗的临床特征的研究详见表格。描述与神经元细胞表面自身抗体（NSAbs）相关的自身免疫性癫痫的临床表现和治疗的文献主要限于回顾性病例系列。我们系统地总结了癫痫病学家特别感兴趣的特征，将患者分为与癫痫相关的急性或亚急性脑病患者和无脑病的慢性癫痫患者。现有的观察性研究表明，免疫疗法在某些临床情况下是有效的，但结果数据收集方法需要更大的标准化。所获得的临床经验表明，临床特征群与特定NSAb密切相关。当患者出现自身抗体相关性脑病时，应进行强化和早期免疫治疗。目前尚不清楚如何评估和治疗慢性癫痫患者和相同的自身抗体。本文中的表格为系统描述临床特征和治疗提供了全面的资源，并强调了当前研究的局限性。
The field of autoimmune epilepsies has increasing relevance to general epileptology. Established clinical features often associate closely with autoantibody specificities. The diseases often respond well to early immunotherapies plus rapid escalation. Randomized controlled trials are eagerly awaited. The growing recognition of epilepsies and encephalopathies associated with autoantibodies against surface neuronal proteins (LGI1, NMDAR, CASPR2, GABABR, and AMPAR) means that epileptologists are increasingly asking questions about mechanisms of antibody-mediated epileptogenesis, and about the use of immunotherapies. This review summarizes clinical and paraclinical observations related to autoimmune epilepsies, examines the current evidence for the effectiveness of immunotherapy, and makes epilepsy-specific recommendations for future research. Systematic literature search with summary and review of the identified publications. Studies describing the clinical characteristics of autoantibody-associated epilepsies and treatments are detailed in tables. Literature describing the clinical manifestations and treatment of autoimmune epilepsies associated with neuronal cell-surface autoantibodies (NSAbs) is largely limited to retrospective case series. We systematically summarize the features of particular interest to epileptologists dividing patients into those with acute or subacute encephalopathies associated with epilepsy, and those with chronic epilepsy without encephalopathy. Available observational studies suggest that immunotherapies are effective in some clinical circumstances but outcome data collection methods require greater standardization. The clinical experience captured suggests that clusters of clinical features associate well with specific NSAbs. Intensive and early immunotherapy is indicated when patients present with autoantibody-associated encephalopathies. It remains unclear how patients with chronic epilepsy and the same autoantibodies should be assessed and treated. Tables in this paper provide a comprehensive resource for systematic descriptions of both clinical features and treatments, and highlight limitations of current studies.
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DOI：
10.1016/j.jpeds.2012.10.011
发表时间：
2013-04
期刊：
The Journal of pediatrics
影响因子：
--
作者：
Armangue T;Titulaer MJ;Málaga I;Bataller L;Gabilondo I;Graus F;Dalmau J;Spanish Anti-N-methyl-D-Aspartate Receptor (NMDAR) Encephalitis Work Group
通讯作者：
Spanish Anti-N-methyl-D-Aspartate Receptor (NMDAR) Encephalitis Work Group
影响因子：
9.9
作者：
Hoeftberger, Romana;Titulaer, Maarten J.;Graus, Francesc
通讯作者：
Graus, Francesc
影响因子：
3.8
作者：
Chan, Sophelia H. S.;Wong, Virginia C. N.;Vincent, Angela
通讯作者：
Vincent, Angela
影响因子：
48
作者：
Dalmau, Josep;Gleichman, Amy J.;Hughes, Ethen G.;Rossi, Jeffrey E.;Peng, Xiaoyu;Lai, Meizan;Dessain, Scott K.;Rosenfeld, Mynna R.;Balice-Gordon, Rita;Lynch, David R.
通讯作者：
Lynch, David R.
影响因子：
11.2
作者：
Dahm, Liane;Ott, Christoph;Ehrenreich, Hannelore
通讯作者：
Ehrenreich, Hannelore