癫痫
自身免疫性脑炎
医学
免疫学
免疫系统
免疫失调
自身免疫
自身免疫性疾病
疾病
自身抗体
内科学
抗体
精神科
作者
Claude Steriade,Maarten J. Titulaer,Annamaria Vezzani,Josemir W. Sander,Roland D. Thijs
出处
期刊:Brain
[Oxford University Press]
日期:2020-11-22
卷期号:144 (2): 372-390
被引量:23
标识
DOI:10.1093/brain/awaa362
摘要
Abstract Systemic autoimmune disorders occur more frequently in patients with epilepsy than in the general population, suggesting shared disease mechanisms. The risk of epilepsy is elevated across the spectrum of systemic autoimmune disorders but is highest in systemic lupus erythematosus and type 1 diabetes mellitus. Vascular and metabolic factors are the most important mediators between systemic autoimmune disorders and epilepsy. Systemic immune dysfunction can also affect neuronal excitability, not only through innate immune activation and blood–brain barrier dysfunction in most epilepsies but also adaptive immunity in autoimmune encephalitis. The presence of systemic autoimmune disorders in subjects with acute seizures warrants evaluation for infectious, vascular, toxic and metabolic causes of acute symptomatic seizures, but clinical signs of autoimmune encephalitis should not be missed. Immunosuppressive medications may have antiseizure properties and trigger certain drug interactions with antiseizure treatments. A better understanding of mechanisms underlying the co-existence of epilepsy and systemic autoimmune disorders is needed to guide new antiseizure and anti-epileptogenic treatments. This review aims to summarize the epidemiological evidence for systemic autoimmune disorders as comorbidities of epilepsy, explore potential immune and non-immune mechanisms, and provide practical implications on diagnostic and therapeutic approach to epilepsy in those with comorbid systemic autoimmune disorders.
科研通智能强力驱动
Strongly Powered by AbleSci AI