Autoimmune Epilepsy: The Evolving Science of Neural Autoimmunity and Its Impact on Epilepsy Management

Seminars in Neurology
Amy M L Quek, Orna O'Toole

Abstract

Autoimmune epilepsy is increasingly recognized as a distinct clinical entity, driven in large part by the recent discovery of neural autoantibodies in patients with isolated or predominant epilepsy presentations. Detection of neural autoantibodies in high-risk epilepsy patients supports an immune-mediated cause of seizures and, if applicable, directs the search for an underlying cancer when the paraneoplastic association of the associated antibody is compelling. Early diagnosis of autoimmune epilepsy is crucial, as prompt initiation of immunosuppressive treatment increases the likelihood of achieving either seizure freedom or a substantial reduction in seizure frequency. A practical clinical approach that incorporates risk scores to guide patient selection on the basis of clinical features, neural autoantibodies, and a treatment trial of immunotherapy is suggested. Elucidating an immunological basis of epilepsy provides neurologists with wider treatment options (incorporating immune-suppressive treatment), in addition to standard antiepileptic drugs, which often improves patient outcomes.

Citations

May 22, 2020·Journal of Pediatric Endocrinology & Metabolism : JPEM·Rumyana DimovaTsvetalina Tankova
Feb 25, 2020·Case Reports in Immunology·Sinali O SeneviratneMastura Monif
Jun 27, 2019·Neurotherapeutics : the Journal of the American Society for Experimental NeuroTherapeutics·Khalil S Husari, Divyanshu Dubey
Dec 15, 2020·Epilepsia·Tracie Huey-Lin TanMastura Monif
Jul 10, 2019·Epilepsy & Behavior : E&B·Boulenouar MesraouaAli A Asadi-Pooya
Jan 1, 2021·Contrast Media & Molecular Imaging·Limei LuoZucai Xu
Jun 17, 2021·Neurology. Neuroimmunology and Neuroinflammation·Justin R AbbatemarcoStacey L Clardy
Aug 8, 2020·Seizure : the Journal of the British Epilepsy Association·Wei-Ping LiuChang Zeng

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Autoimmune diseases occur as a result of an attack by the immune system on the body’s own tissues resulting in damage and dysfunction. There are different types of autoimmune diseases, in which there is a complex and unknown interaction between genetics and the environment. Discover the latest research on autoimmune diseases here.

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