癫痫的自身免疫性病因研究进展概述

Overview of research progress on autoimmune etiology of epilepsy

针对“自身免疫性癫痫”概念在使用上出现的争议,国际抗癫痫联盟提出了“继发于自身免疫性脑炎的急性症状性痫性发作(ASSAE)”和“自身免疫性脑炎相关癫痫(AEAE)”,这两者在主要致病性抗体、病理学改变、治疗方案、预后上都有很大的差异。文中拟从定义、流行病学、病因、临床表现、诊断和治疗方面对这2个新概念进行全面解读,以期解决临床上对于ASSAE和AEAE的诊疗过程中存在的问题,加深神经科医师对于癫痫的自身免疫性病因的了解。

In response to the controversial use of the concept of"autoimmune epilepsy",the International League Against Epilepsy has proposed conceptual definitions for 2 main diagnostic entities:acute symptomatic seizures secondary to autoimmune encephalitis(ASSAE)and autoimmune encephalitis-associated epilepsy(AEAE),which differ greatly in terms of major pathogenic antibodies,pathological changes,treatment options,and prognosis.In this review,a comprehensive interpretation of these 2 new concepts in terms of definition,epidemiology,aetiology,clinical manifestations,diagnosis and treatment is fully discussed,with the aim of addressing clinical issues in the treatment of ASSAE and AEAE,deepening neurologists′understanding of autoimmune etiology of epilepsy.