Antibody-associated epilepsies: clinical features, evidence for immunotherapies and future research questions
<h4>Objectives</h4> <p>The growing recognition of epilepsies and encephalopathies associated with autoantibodies against surface neuronal proteins (LGI1, NMDAR, CASPR2, GABABR, and AMPAR) means that epileptologists are increasingly asking questions about mechanisms of antibody-medi...
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| Format: | Journal article |
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Elsevier
2016
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| _version_ | 1826287529323659264 |
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| author | Irani, S Reuber, M Bakpa, O |
| author_facet | Irani, S Reuber, M Bakpa, O |
| author_sort | Irani, S |
| collection | OXFORD |
| description | <h4>Objectives</h4> <p>The growing recognition of epilepsies and encephalopathies associated with autoantibodies against surface neuronal proteins (LGI1, NMDAR, CASPR2, GABABR, and AMPAR) means that epileptologists are increasingly asking questions about mechanisms of antibody-mediated epileptogenesis, and about the use of immunotherapies. This review summarizes clinical and paraclinical observations related to autoimmune epilepsies, examines the current evidence for the effectiveness of immunotherapy, and makes epilepsy-specific recommendations for future research.</p> <h4>Methods</h4> <p>Systematic literature search with summary and review of the identified publications. Studies describing the clinical characteristics of autoantibody-associated epilepsies and treatments are detailed in tables.</p> <h4>Results</h4> <p>Literature describing the clinical manifestations and treatment of autoimmune epilepsies associated with neuronal cell-surface autoantibodies (NSAbs) is largely limited to retrospective case series. We systematically summarise the features of particular interest to epileptologists dividing patients into those with acute or subacute encephalopathies associated with epilepsy, and those with chronic epilepsy without encephalopathy. Available observational studies suggest that immunotherapies are effective in some clinical circumstances but outcome data collection methods require greater standardisation.</p> <h4>Conclusions</h4> <p>The clinical experience captured suggests that clusters of clinical features associate well with specific NSAbs. Intensive and early immunotherapy is indicated when patients present with autoantibody-associated encephalopathies. It remains unclear how patients with chronic epilepsy and the same autoantibodies should be assessed and treated. Tables in this paper provide a comprehensive resource for systematic descriptions of both clinical features and treatments, and highlight limitations of current studies.</p> |
| first_indexed | 2024-03-07T02:00:02Z |
| format | Journal article |
| id | oxford-uuid:9d0dd645-ba36-4731-b48b-32bc71fc3954 |
| institution | University of Oxford |
| last_indexed | 2024-03-07T02:00:02Z |
| publishDate | 2016 |
| publisher | Elsevier |
| record_format | dspace |
| spelling | oxford-uuid:9d0dd645-ba36-4731-b48b-32bc71fc39542022-03-27T00:40:14ZAntibody-associated epilepsies: clinical features, evidence for immunotherapies and future research questionsJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:9d0dd645-ba36-4731-b48b-32bc71fc3954Symplectic Elements at OxfordElsevier2016Irani, SReuber, MBakpa, O<h4>Objectives</h4> <p>The growing recognition of epilepsies and encephalopathies associated with autoantibodies against surface neuronal proteins (LGI1, NMDAR, CASPR2, GABABR, and AMPAR) means that epileptologists are increasingly asking questions about mechanisms of antibody-mediated epileptogenesis, and about the use of immunotherapies. This review summarizes clinical and paraclinical observations related to autoimmune epilepsies, examines the current evidence for the effectiveness of immunotherapy, and makes epilepsy-specific recommendations for future research.</p> <h4>Methods</h4> <p>Systematic literature search with summary and review of the identified publications. Studies describing the clinical characteristics of autoantibody-associated epilepsies and treatments are detailed in tables.</p> <h4>Results</h4> <p>Literature describing the clinical manifestations and treatment of autoimmune epilepsies associated with neuronal cell-surface autoantibodies (NSAbs) is largely limited to retrospective case series. We systematically summarise the features of particular interest to epileptologists dividing patients into those with acute or subacute encephalopathies associated with epilepsy, and those with chronic epilepsy without encephalopathy. Available observational studies suggest that immunotherapies are effective in some clinical circumstances but outcome data collection methods require greater standardisation.</p> <h4>Conclusions</h4> <p>The clinical experience captured suggests that clusters of clinical features associate well with specific NSAbs. Intensive and early immunotherapy is indicated when patients present with autoantibody-associated encephalopathies. It remains unclear how patients with chronic epilepsy and the same autoantibodies should be assessed and treated. Tables in this paper provide a comprehensive resource for systematic descriptions of both clinical features and treatments, and highlight limitations of current studies.</p> |
| spellingShingle | Irani, S Reuber, M Bakpa, O Antibody-associated epilepsies: clinical features, evidence for immunotherapies and future research questions |
| title | Antibody-associated epilepsies: clinical features, evidence for immunotherapies and future research questions |
| title_full | Antibody-associated epilepsies: clinical features, evidence for immunotherapies and future research questions |
| title_fullStr | Antibody-associated epilepsies: clinical features, evidence for immunotherapies and future research questions |
| title_full_unstemmed | Antibody-associated epilepsies: clinical features, evidence for immunotherapies and future research questions |
| title_short | Antibody-associated epilepsies: clinical features, evidence for immunotherapies and future research questions |
| title_sort | antibody associated epilepsies clinical features evidence for immunotherapies and future research questions |
| work_keys_str_mv | AT iranis antibodyassociatedepilepsiesclinicalfeaturesevidenceforimmunotherapiesandfutureresearchquestions AT reuberm antibodyassociatedepilepsiesclinicalfeaturesevidenceforimmunotherapiesandfutureresearchquestions AT bakpao antibodyassociatedepilepsiesclinicalfeaturesevidenceforimmunotherapiesandfutureresearchquestions |