Autoimmune epilepsy

概述

Autoimmune epilepsy is a type of epilepsy where seizures are caused by the immune system mistakenly attacking brain cells. It can occur with conditions that affect the immune system, especially autoimmune encephalitis.

Autoimmune epilepsy also is known as autoimmune associated epilepsy and acute symptomatic seizures secondary to autoimmune encephalitis.

The immune system protects the body from viruses, bacteria and other substances that can cause illnesses. Antibodies are proteins that are part of the immune system. In autoimmune epilepsy, antibodies mistakenly target receptors in the brain. This leads to swelling in the brain, also known as inflammation, and seizures.

Antiseizure medicines usually don't do enough to manage seizures in people with autoimmune epilepsy. Instead, immunotherapy medicines help reduce the immune response on the brain.

When immunotherapy is started early, it can reduce inflammation and improve seizures. For some people, treatment can stop seizures completely. For others, seizures may continue after treatment.

症状

Symptoms of autoimmune epilepsy may begin after an illness with a fever. Seizures come on suddenly and are serious. The types of seizures that may occur include:

• Focal seizures. These are the most common type of seizure in autoimmune epilepsy. Sometimes focal seizures cause a change or loss of awareness. The seizures may cause the person to stare and not respond to the environment. Other types of focal seizures don't cause a change in awareness. These seizures cause different symptoms depending on which part of the brain causes them. Focal seizures may cause one part of the body to shake. Or they may cause a feeling that his has happened before, known as déjà vu. Focal seizures also may cause nausea or vision symptoms, such as flashing lights.
• Faciobrachial dystonic seizures. These seizures cause muscle contractions on one side of the face and in an arm, both on the same side of the body.

Symptoms related to seizures include:

• Seizures that happen several times a day.
• Seizures that don't go away with antiseizure medicines.
• Seizures that last more than five minutes or that occur close together without the person regaining consciousness, known as status epilepticus.

Autoimmune epilepsy symptoms also may include:

• Memory loss and trouble with thinking.
• Personality and behavior changes.
• Involuntary movements or clumsy movements.
• Irregular eye movements.
• Changes in heart rate, blood pressure and other automatic functions.

When to see a doctor

Get emergency medical care if you or someone you are with has a seizure that lasts more than five minutes or if seizures occur one after another with a loss of consciousness. Also seek emergency medical care for high fevers or trouble breathing.

See your healthcare professional right away if you have had a seizure for the first time or if you have other symptoms of autoimmune epilepsy.

病因

Autoimmune epilepsy is caused by the immune system attacking brain cells and leading to seizures. Antibodies are part of the immune system. They usually protect the body from viruses and infections. But in autoimmune conditions, the immune system attacks healthy cells. More recently, research has concluded that epilepsy can be an autoimmune disease.

Autoimmune epilepsy causes may include:

• Autoimmune encephalitis. Autoimmune encephalitis (en-sef-uh-LIE-tis) is a group of conditions that causes swelling in the brain. This happens because the immune system mistakenly attacks brain cells. Autoimmune encephalitis causes a variety of symptoms, including seizures. It is the most common cause of autoimmune epilepsy. Certain types of autoimmune encephalitis are commonly linked to autoimmune epilepsy and are associated with antibodies that target NMDA-receptors, LGI1, CASPR2 and GAD65.
• Rasmussen syndrome. In this condition, immune cells known as T cells cause inflammation and brain damage that lead to seizures. People with autoimmune epilepsy due to Rasmussen syndrome may continue to have seizures after treatment.
• Cancer. Sometimes tumors trigger the immune system to attack healthy brain cells, known as paraneoplastic syndrome. This can lead to epilepsy.

风险因素

The risk of autoimmune epilepsy is low, but it can occur in both adults and children. Risk factors include:

• Having another autoimmune disease. These may include rheumatoid arthritis, Graves' disease, Hashimoto thyroiditis, Crohn's disease, ulcerative colitis or lupus.
• Having a history of cancer.
• Having a parent, sibling or child with an autoimmune disease.

并发症

Autoimmune epilepsy complications can include serious seizures that last more than five minutes or occur one after another. The person isn't conscious in between the seizures. These serious seizures are known as status epilepticus. They need emergency medical attention.

Sometimes autoimmune epilepsy can lead to seizures that don't stop with treatment.

预防

You may not be able to prevent autoimmune epilepsy. But getting cancer screenings can help your healthcare professional find tumors and treat them early. This could prevent autoimmune encephalitis triggered by cancers, which can be a cause of epilepsy. Talk with your healthcare professional about your cancer risk and if you should get screened for certain cancers.