Systemic and neurologic autoimmune disorders associated with seizures or epilepsy
Systemic and neurologic autoimmune disorders associated with seizures or epilepsy
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DOI：
10.1111/j.1528-1167.2011.03030.x
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发表时间：
2011-05-01
期刊：
影响因子：
5.6
通讯作者：
Crino, Peter B.
中科院分区：
文献类型：
--
作者：
Vincent, Angela;Crino, Peter B.
在这篇文章中，我们回顾了癫痫发作的发病率和意义的自身免疫性疾病，包括多发性硬化症（MS），糖尿病，乳糜泻，甲状腺疾病，系统性红斑狼疮（SLE）。以下五个介绍讨论了癫痫的发病率和可能的发病机制，发现在这些众所周知的自身免疫性疾病。有大量的证据描述了MS和SLE癫痫发作的临床表现，并显示难治性癫痫可使这些已经具有挑战性的疾病复杂化。然而，所涉及的机制是复杂的，而且通常没有得到很好的理解。神经系统综合征，包括癫痫发作，也可以是乳糜泻（CD）或亚临床CD的特征，有时与脑钙化相关。1型糖尿病（T1 DM）和癫痫之间的关联尚不清楚，需要更明确的流行病学分析，尽管谷氨酸脱羧酶抗体可能提供两种疾病之间的联系。甲状腺疾病和脑病（通常称为桥本脑病）之间的关联是众所周知的，但抗甲状腺抗体在这种情况下的致病意义仍有争议。一般来说，在这些条件下，自身免疫机制和癫痫发作之间的关系尚不清楚;癫痫发作可能是由多种机制引起的，包括缺血，神经元损伤，特异性和非特异性免疫。
P>In this article, we review the incidence and significance of seizures in well-established autoimmune disorders, including multiple sclerosis (MS), diabetes mellitus, celiac disease, thyroid disease, and systemic lupus erythematosus (SLE). The five following presentations discuss the incidence and possible pathogenesis of epilepsies that are found in these well-known autoimmune conditions. There is a large body of evidence describing the clinical presentation of seizures with MS and SLE, and showing that refractory epilepsy can complicate these already challenging disorders. However, the mechanisms involved are complex and generally not well understood. Neurologic syndromes, including seizure disorders, can also be a feature of celiac disease (CD) or subclinical CD, sometimes associated with cerebral calcification. The association between type-1 diabetes mellitus (T1DM) and epilepsy is unclear and requires more definitive epidemiologic analysis, despite the fact that antibodies to glutamic acid decarboxylase may provide a link between the two conditions. The association between thyroid disorders and encephalopathies, often termed Hashimoto's encephalopathy, is well known but the pathogenic significance of antithyroid antibodies in this condition is still debated. In general, the relationships between autoimmune mechanisms and seizures in these conditions are unclear; the seizures are likely to be caused by a variety of mechanisms, including ischemia, neuronal damage, and specific and nonspecific immunity.