自身免疫性脑炎急性症状性痫性发作和自身免疫相关性癫痫的诊治进展  

Advances in the diagnosis and treatment of acute symptomatic seizures secondary to autoimmune encephalitis and autoimmune-related epilepsy

作　　者：孙文琳 谢银银 彭婷婷 张海峰[1] 陈媛[1] 马蕴青 谢祎 王翠[1] 连亚军(综述)[1] 谢南昌(审校)[1] SUN Wenlin;XIE Yinyin;PENG Tingting(The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院,河南郑州450052

出　　处：《中风与神经疾病杂志》2024年第6期515-520,共6页Journal of Apoplexy and Nervous Diseases

基　　金：国家自然科学基金(81971214)。

摘　　要：自身免疫性脑炎急性症状性痫性发作指发生在免疫介导性脑炎活动期的癫痫发作。自身免疫相关性癫痫是指存在免疫病因,并有长期无诱因癫痫发作倾向的疾病。两者通常都对抗癫痫发作药物反应差,早期识别免疫病因并开始免疫治疗或许能帮助患者达到良好的预后。但目前尚无针对不同类型脑炎痫性发作的药物使用准则,自身免疫相关性癫痫也缺乏诊断标准和治疗原则。本文综述并讨论了两者可能的发病机制、临床表现和推荐的治疗方法,旨在为两者的诊治提供理论依据,并对未来的研究方向有所帮助。Acute symptomatic seizures secondary to autoimmune encephalitis refers to seizures that occur during the active stage of immune-mediated encephalitis,and autoimmune-related epilepsy refers to disorders with an immune etiology and a long-term predisposition to unprovoked seizures.Both diseases often have poor response to antiepileptic drugs,and early identification of immune etiology and initiation of immunotherapy may help patients achieve a good prognosis.However,there are no guidelines for the use of drugs in patients with different types of symptomatic seizures,and there is also a lack of diagnostic criteria and treatment principles for autoimmune-related epilepsy.This article reviews and discusses the two diseases from the aspects of possible pathogenesis,clinical manifestations,and recommended treatment methods,so as to provide a theoretical basis for diagnosis and treatment and help to determine future research directions.

关 键 词：癫痫 自身免疫性脑炎 急性症状性痫性发作 自身免疫相关性癫痫 

分 类 号：R742.1[医药卫生—神经病学与精神病学]