自身免疫因素与癫痫的相关性

摘要

Epilepsy is a common chronic brain disorder with multiple causes,and now autoimmune factors are believed to be an independent cause for epilepsy.Accumulating data support an autoimmune basis in patients with antiepileptic drug-resistant seizures.Moreover,systemic autoimmune diseases and epilepsy co-occur frequently.Neural specific autoantibodies can also mediate the process of seizures through different pathways,The diagnosis of autoimmune epilepsy is based on frequency of antiepileptic drug-resistant seizures,the presence of neural specific autoantibodies,inflammatory changes in serum or spinal fluid or on magneticresonanceimaging,the change in electroencephalogram,a personal or family history of autoimmunity.Once autoimmune epilepsy is diagnosed,the immunotherapy is required.Early immunotherapy is crucial for improving the prognosis of the patients.%癫痫是一类常见的慢性脑部疾病,病因复杂多样,目前自身免疫因素已成为癫痫的独立病因.有证据表明药物难治性癫痫的发生与自身免疫机制相关,并且系统性自身免疫性疾病可合并癫痫发作,神经元特异性细胞内或细胞膜抗体也可通过不同途径介导癫痫发作.频繁的癫痫发作,对抗癫痫药物反应不佳,特异性抗神经元抗体的检出,血清、脑脊液的炎性改变,脑电图和磁共振成像的改变,以及免疫性疾病的病史或家族史等有助于自身免疫性癫痫的诊断.一旦确诊为自身免疫性癫痫则须行免疫治疗,尽早行免疫治疗对于改善患者预后至关重要.