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Inflammation, ictogenesis, and epileptogenesis: An exploration through human disease.
Tan, Tracie Huey-Lin; Perucca, Piero; O'Brien, Terence J; Kwan, Patrick; Monif, Mastura.
Afiliação
  • Tan TH; Department of Neuroscience, Central Clinical School, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Victoria, Australia.
  • Perucca P; Department of Neurology, Alfred Hospital, Melbourne, Victoria, Australia.
  • O'Brien TJ; Department of Neurology, Royal Melbourne Hospital, Melbourne, Victoria, Australia.
  • Kwan P; Department of Neuroscience, Central Clinical School, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Victoria, Australia.
  • Monif M; Department of Neurology, Alfred Hospital, Melbourne, Victoria, Australia.
Epilepsia ; 62(2): 303-324, 2021 02.
Article em En | MEDLINE | ID: mdl-33316111
ABSTRACT
Epilepsy is seen historically as a disease of aberrant neuronal signaling manifesting as seizures. With the discovery of numerous auto-antibodies and the subsequent growth in understanding of autoimmune encephalitis, there has been an increasing emphasis on the contribution of the innate and adaptive immune system to ictogenesis and epileptogenesis. Pathogenic antibodies, complement activation, CD8+ cytotoxic T cells, and microglial activation are seen, to various degrees, in different seizure-associated neuroinflammatory and autoimmune conditions. These aberrant immune responses are thought to cause disruptions in neuronal signaling, generation of acute symptomatic seizures, and, in some cases, the development of long-term autoimmune epilepsy. Although early treatment with immunomodulatory therapies improves outcomes in autoimmune encephalitides and autoimmune epilepsies, patient identification and treatment selection are not always clear-cut. This review examines the role of the different components of the immune system in various forms of seizure disorders including autoimmune encephalitis, autoimmune epilepsy, Rasmussen encephalitis, febrile infection-related epilepsy syndrome (FIRES), and new-onset refractory status epilepticus (NORSE). In particular, the pathophysiology and unique cytokine profiles seen in these disorders and their links with diagnosis, prognosis, and treatment decision-making are discussed.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Estado Epiléptico / Doenças Autoimunes do Sistema Nervoso / Encefalite / Epilepsia / Inflamação Tipo de estudo: Prognostic_studies Limite: Humans Idioma: En Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Estado Epiléptico / Doenças Autoimunes do Sistema Nervoso / Encefalite / Epilepsia / Inflamação Tipo de estudo: Prognostic_studies Limite: Humans Idioma: En Ano de publicação: 2021 Tipo de documento: Article