抗體介導的自身免疫性腦炎患者的癲癇特點_Journal of Epilepsy

Authors：

 VogrigAlberto , JoubertBastien , Andre-ObadiaNathalie , 陳鄧 , 慕潔

Corresponding?author：

VogrigAlberto, Email: jerome.honnorat@chu-lyon.fr

Keywords：

自身免疫性疾病; 腦電圖; 腦炎; 癲癇; 副腫瘤綜合征; 癲癇發作

DOI：

10.7507/2096-0247.20200043

Video：

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Abstract Full text Figures/Tables Video References Cited by

越來越多的自身免疫性腦炎（Autoimmune encephalitis，AE）患者的資料顯示，其臨床表現和結局的特異性依賴于患者腦脊液、血清中特定抗原的抗體。這些特異性包括了癲癇相關的臨床表現及對抗癲癇藥物的反應。雖然學者們對這一類疾病的研究熱情不斷增加，且發現了新的抗體和相關的臨床綜合征，但仍有一些問題需要進一步解答。首先，鑒于每一種自身免疫性抗體介導的綜合征的嚴重程度、患者特點、治療時間不盡相同，治療需要個體化；其次，缺乏隨機對照試驗是形成適當的免疫治療策略的重大障礙。文章就一些已闡明的 AE 患者的癲癇診斷和治療方面的新進展和挑戰作一綜述，并闡述在這一新興領域中合理應用精確藥物的原則。

Citation： VogrigAlberto, JoubertBastien, Andre-ObadiaNathalie, 陳鄧, 慕潔. 抗體介導的自身免疫性腦炎患者的癲癇特點. Journal of Epilepsy, 2020, 6(3): 235-248. doi: 10.7507/2096-0247.20200043 Copy

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1. Britton J. Autoimmune epilepsy. Handb Clin Neurol, 2016, 133: 219-245.
2. Leypoldt F, Armangue T, Dalmau J. Autoimmune encephalopathies. Ann N Y Acad Sci, 2015, 1338: 94-114.
3. Giometto B, Grisold W, Vitaliani R, et al. Paraneoplastic neurologic syndrome in the PNS Euronetwork database: a European study from 20 centers. Arch Neurol, 2010, 67(3): 330-335.
4. Lancaster E, Dalmau J. Neuronal autoantigens-pathogenesis, associated disorders and antibody testing. Nat Rev Neurol, 2012, 8(7): 380-390.
5. Kim TJ, Lee ST, Moon J, et al. Anti-LGI1 encephalitis is associated with unique HLA subtypes. Ann Neurol, 2017, 81(2): 183-192.
6. van Sonderen A, Roelen DL, Stoop JA, et al. Anti-LGI1 encephalitis is strongly associated with HLA-DR7 and HLA-DRB4. Ann Neurol, 2017, 81(2): 193-198.
7. Huijbers MG, Querol LA, Niks EH, et al. The expanding field of IgG4-mediated neurological autoimmune disorders. Eur J Neurol, 2015, 22(8): 1151-1161.
8. Manto M, Dalmau J, Didelot A, et al. In vivo effects of antibodies from patients with anti-NMDA receptor encephalitis: further evidence of synaptic glutamatergic dysfunction. Orphanet J Rare Dis, 2010, 5: 31.
9. Moscato EH, Peng X, Jain A, et al. Acute mechanisms underlying antibody effects in anti-N-methyl-D-aspartate receptor encephalitis. Ann Neurol, 2014, 76(1): 108-119.
10. Petit-Pedrol M, Sell J, Planagumà J, et al. LGI1 antibodies alter Kv1.1 and AMPA receptors changing synaptic excitability, plasticity and memory. Brain, 2018, 141(11): 3144-3159.
11. Daif A, Lukas RV, Issa NP, et al. Antiglutamic acid decarboxylase 65 (GAD65) antibody-associated epilepsy. Epilepsy Behav, 2018, 80: 331-336.
12. Dalmau J, Lancaster E, Martinez-Hernandez E, et al. Clinical experience and laboratory investigations in patients with anti-NMDAR encephalitis. Lancet Neurol, 2011, 10(1): 63-74.
13. Dalmau J, Gleichman AJ, Hughes EG, et al. Anti-NMDA-receptor encephalitis: case series and analysis of the effects of antibodies. Lancet Neurol, 2008, 7(12): 1091-1098.
14. Gillinder L, Warren N, Hartel G, et al. EEG findings in NMDA encephalitis-A systematic review. Seizure, 2019, 65: 20-24.
15. Baykan B, Gungor Tuncer O, Vanli-Yavuz EN, et al. Delta brush pattern is not unique to NMDAR encephalitis: Evaluation of two independent long-term EEG cohorts. Clin EEG Neurosci, 2018, 49(4): 278-284.
16. Jeannin-Mayer S, André-Obadia N, Rosenberg S, et al. EEG analysis in anti-NMDA receptor encephalitis: Description of typical patterns. Clin Neurophysiol, 2019, 130(2): 289-296.
17. Liu X, Yan B, Wang R, et al. Seizure outcomes in patients with anti-NMDAR encephalitis: A follow-up study. Epilepsia, 2017, 58(12): 2104-2111.
18. de Montmollin E, Demeret S, Brulé N, et al. Anti-N-Methyl-d-Aspartate receptor encephalitis in adult patients requiring intensive care. Am J Respir Crit Care Med, 2017, 195(4): 491-499.
19. Titulaer MJ, Mc Cracken L, Gabilondo I, et al. Treatment and prognostic factors for long-term outcome in patients with anti-NMDA receptor encephalitis: an observational cohort study. Lancet Neurol, 2013, 12(2): 157-165.
20. Viaccoz A, Desestret V, Ducray F, et al. Clinical specificities of adult male patients with NMDA receptor antibodies encephalitis. Neurology, 2014, 82(7): 556-563.
21. Zekeridou A, Karantoni E, Viaccoz A, et al. Treatment and outcome of children and adolescents with N-methyl-D-aspartate receptor encephalitis. J Neurol, 2015, 262(8): 1859-1866.
22. Sonderen AV, Arends S, Tavy DLJ, et al. Predictive value of electroencephalography in anti-NMDA receptor encephalitis. J Neurol Neurosurg Psychiatry, 2018, 89(10): 1101-1106.
23. Schmitt SE, Pargeon K, Frechette ES, et al. Extreme delta brush: a unique EEG pattern in adults with anti-NMDA receptor encephalitis. Neurology, 2012, 79(11): 1094-1100.
24. Armangue T, Titulaer MJ, Málaga I, et al. Pediatric anti-N-methyl-D-aspartate receptor encephalitis-clinical analysis and novel findings in a series of 20 patients. J Pediatr, 2013, 162(4): 850-856.
25. Veciana M, Becerra JL, Fossas P, et al. EEG extreme delta brush: An ictal pattern in patients with anti-NMDA receptor encephalitis. Epilepsy Behav, 2015, 49: 280-285.
26. Lai M, Hughes EG, Peng X, et al. AMPA receptor antibodies in limbic encephalitis alter synaptic receptor location. Ann Neurol, 2009, 65(4): 424-434.
27. Joubert B, Kerschen P, Zekeridou A, et al. Clinical spectrum of encephalitis associated with antibodies against the α-Amino-3-Hydroxy-5-Methyl-4-Isoxazolepropionic acid receptor: Case series and review of the literature. JAMA Neurol, 2015, 72(10): 1163-1169.
28. H?ftberger R, van Sonderen A, Leypoldt F, et al. Encephalitis and AMPA receptor antibodies: Novel findings in a case series of 22 patients. Neurology, 2015, 84(24): 2403-2412.
29. Dogan Onugoren M, Deuretzbacher D, Haensch CA, et al. Limbic encephalitis due to GABAB and AMPA receptor antibodies: a case series. J Neurol Neurosurg Psychiatry, 2015, 86(9): 965-972.
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