神経学的障害

The Clinical Spectrum of Autoimmune Epilepsy in Children: With Cases Illustrations

Abstract

Muhammad Akbar Malik

There are many causes of seizures in autoimmune disorders of brain, and the first clinical Seizures are among the most common neurological manifestation. Occasionally seizures can be the presenting symptom, convert into epilepsy, may be detected up to 14% of epilepsy patient, which could herald a life-threatening progression of the underlying illness. However, existing criteria for autoimmune epilepsy are too reliant on antibody testing and response to immunotherapy, which might delay the diagnosis. Because autoantibody test results and response to therapy are not available at disease onset, the initial diagnostic approach should be on neurological assessment and conventional tests that are accessible to most clinicians. Through logical differential diagnosis, levels of evidence for autoimmune epilepsy (possible, probable, or definite) may be achieved, which can lead to prompt immunotherapy. Prompt recognition of these disorders is mandatory to offer the patient adopted therapeutic options. Neuronal surface antibody and intracellular antibody syndromes encompass a variety of disorders associated with severe epilepsy. These share clinical and neuroradiological features that pose challenges related to their recognition and treatment. On that basis, a target treatment can be started, anti-seizure drugs augmented with corticosteroids and intravenous immunoglobulin or plasma exchange as a first-line immunotherapy, followed by second-line drugs including rituximab, cyclophosphamide or mycophenolate mophetil, if the case. In children a prompt diagnosis and a targeted treatment may lead to a better clinical outcome.