自身免疫性癫痫的临床研究进展

发布时间：2018-05-30 01:41

本文选题：癫痫 + 自身免疫　；参考：《神经病学与神经康复学杂志》2016年02期

【摘要】：许多研究表明,药物难治性癫痫的发生可能与自身免疫炎性机制相关,神经元特异性细胞内或细胞膜抗体通过不同途径促使癫痫发作。癫痫发作的症状学、神经元特异性抗体、炎性脑脊液、磁共振成像和脑电图等,均有助于诊断自身免疫性癫痫。免疫治疗有望成为有效治疗自身免疫机制介导的药物难治性癫痫的新手段。免疫治疗药物包括糖皮质激素、静脉用免疫球蛋白、环磷酰胺、利妥昔单抗和硫唑嘌呤等。近年来的研究发现,环孢霉素A、他克莫司和雷帕霉素这3种免疫抑制剂对自身免疫性癫痫有效。此外,血浆置换也是急性期的治疗选择之一。自身免疫性癫痫患者接受急性期早期免疫治疗与稳定期维持治疗后,有望获得较好的预后。本文对自身免疫性癫痫的发病机制、临床特征、诊断和治疗的研究进展进行综述。
[Abstract]:Many studies have shown that the occurrence of drug-resistant epilepsy may be related to the autoimmune inflammatory mechanism, neuron-specific intracellular or cell membrane antibodies promote seizures through different channels. Symptoms, neuron-specific antibodies, inflammatory cerebrospinal fluid (CSF), magnetic resonance imaging (MRI) and electroencephalogram (EEG) are all helpful in the diagnosis of autoimmune epilepsy. Immunotherapy is expected to be a new method for the treatment of drug-resistant epilepsy mediated by autoimmune mechanism. Immunotherapeutic drugs include glucocorticoids, intravenous immunoglobulin, cyclophosphamide, rituximab and azathioprine. In recent years, three immunosuppressants, cyclosporine A, tacrolimus and rapamycin, have been found to be effective in the treatment of autoimmune epilepsy. In addition, plasma exchange is also one of the treatment options in the acute phase. Early immunotherapy and maintenance therapy in autoimmune epilepsy patients are expected to have a good prognosis. This article reviews the pathogenesis, clinical features, diagnosis and treatment of autoimmune epilepsy.
【作者单位】：上海交通大学医学院;上海交通大学医学院附属仁济医院神经内科;
【基金】：上海市自然科学基金资助项目(编号:15ZR1412900)~~
【分类号】：R742.1

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