癫痫免疫性病因研究进展  

Research progress on immunological etiology of epilepsy

作　　者：魏伟 魏良豪 狄晴[1] WEI Wei;WEI Liang Hao;DI Qing(Department of Neurology,the Affiliated Nanjing Brain Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学附属脑科医院神经内科,南京210029

出　　处：《中国神经精神疾病杂志》2022年第2期121-124,共4页Chinese Journal of Nervous and Mental Diseases

摘　　要：免疫性癫痫在癫痫患者中占比不低,癫痫的免疫性病因应受到更多重视。自身免疫相关性癫痫(autoimmune-associated epilepsy,AAE)指自身免疫性脑炎(autoimmune encephalitis,AIE)后遗留的慢性癫痫发作,AIE患者神经特异性抗体(neural specific autoantibodies,NSAbs)类型不同,发生AAE的比例也不同,早期免疫治疗是预防AAE发生的重要预防措施。在不明原因癫痫患者中检出NSAbs同样提示病因为免疫性,这类患者常表现频繁发作、药物难治等特点。近期学者提出多种预测不明原因癫痫患者NSAbs阳性的评分系统,但其有效性仍需进一步研究证实。免疫是癫痫的重要病因,及早诊断和治疗能更好地改善患者的预后,临床医师应加强癫痫免疫性病因的筛查,务求早诊断、早治疗。The proportion of immune epilepsy in epilepsy patients cannot be ignored,and the immune etiology of epilepsy should receive more attention.Autoimmune-associated epilepsy(AAE)refers to the chronic seizures resulted from autoimmune encephalitis(AIE).AIE patients with different types of neural specific autoantibodies(NSAbs)have different rates of AAE,and early immunotherapy is an important preventive measure to prevent the transformation from AIE to AAE.Detecting of NSAbs in epilepsy of unknown cause is also suggestive of an immunologic cause,and these patients often exhibit characteristics such as frequent seizures and resistance to medical treatment.Recently,a variety of scoring systems has been proposed to predict positive NSAbs in epilepsy with unknown cause,but their validity still needs to be confirmed by further studies.Immunity is an important cause of epilepsy.Early diagnosis and immunotherapy can improve the prognosis of patients.Physicians should enhance screening for immunologic causes of epilepsy to ensure early diagnosis and treatment.

关 键 词：癫痫 病因 自身免疫相关性癫痫 自身免疫性脑炎 神经元特异性自身抗体 

分 类 号：R742.1[医药卫生—神经病学与精神病学]