Autoimmune and paraneoplastic seizures
Seizures are a common feature of autoimmune encephalitis and are especially prevalent in patients with the commonest autoantibodies, against LGI1, CASPR2 and the NMDA, GABAB, and GABAA receptors. In this chapter, we discuss the classification, clinical, investigation, and treatment aspects of patien...
| Main Authors: | , |
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| Format: | Book section |
| Language: | English |
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Elsevier
2024
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| _version_ | 1824459237189746688 |
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| author | Wagner, B Irani, S |
| author_facet | Wagner, B Irani, S |
| author_sort | Wagner, B |
| collection | OXFORD |
| description | Seizures are a common feature of autoimmune encephalitis and are especially prevalent in patients with the commonest autoantibodies, against LGI1, CASPR2 and the NMDA, GABAB, and GABAA receptors. In this chapter, we discuss the classification, clinical, investigation, and treatment aspects of patients with these, and other autoantibody-mediated and -associated, illnesses. We highlight distinctive and common seizure semiologies which, often alongside other features we outline, can help the clinical diagnosis of an autoantibody-associated syndrome. Next, we classify these syndromes by either focusing on whether they represent underlying causative autoantibodies or T-cell-mediated syndromes and on the distinction between acute symptomatic seizures and a more enduring tendency to autoimmune-associated epilepsy, a practical and valuable distinction for both patients and clinicians which relates to the pathogenesis. We emphasize the more effective immunotherapy response in patients with causative autoantibodies, and discuss the emerging evidence for various first-, second-, and third-line immunotherapies. Finally, we highlight available clinical rating scales which can guide autoantibody testing and immunotherapy in patients with seizures of unknown etiology. Throughout, we relate the clinical and therapeutic observations to the immunobiology and neuroscience which drive these seizures. |
| first_indexed | 2025-02-19T04:38:35Z |
| format | Book section |
| id | oxford-uuid:df0ac7b0-5c52-4c95-aed1-05fd0086f304 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2025-02-19T04:38:35Z |
| publishDate | 2024 |
| publisher | Elsevier |
| record_format | dspace |
| spelling | oxford-uuid:df0ac7b0-5c52-4c95-aed1-05fd0086f3042025-02-06T16:56:18ZAutoimmune and paraneoplastic seizuresBook sectionhttp://purl.org/coar/resource_type/c_1843uuid:df0ac7b0-5c52-4c95-aed1-05fd0086f304EnglishSymplectic ElementsElsevier2024Wagner, BIrani, SSeizures are a common feature of autoimmune encephalitis and are especially prevalent in patients with the commonest autoantibodies, against LGI1, CASPR2 and the NMDA, GABAB, and GABAA receptors. In this chapter, we discuss the classification, clinical, investigation, and treatment aspects of patients with these, and other autoantibody-mediated and -associated, illnesses. We highlight distinctive and common seizure semiologies which, often alongside other features we outline, can help the clinical diagnosis of an autoantibody-associated syndrome. Next, we classify these syndromes by either focusing on whether they represent underlying causative autoantibodies or T-cell-mediated syndromes and on the distinction between acute symptomatic seizures and a more enduring tendency to autoimmune-associated epilepsy, a practical and valuable distinction for both patients and clinicians which relates to the pathogenesis. We emphasize the more effective immunotherapy response in patients with causative autoantibodies, and discuss the emerging evidence for various first-, second-, and third-line immunotherapies. Finally, we highlight available clinical rating scales which can guide autoantibody testing and immunotherapy in patients with seizures of unknown etiology. Throughout, we relate the clinical and therapeutic observations to the immunobiology and neuroscience which drive these seizures. |
| spellingShingle | Wagner, B Irani, S Autoimmune and paraneoplastic seizures |
| title | Autoimmune and paraneoplastic seizures |
| title_full | Autoimmune and paraneoplastic seizures |
| title_fullStr | Autoimmune and paraneoplastic seizures |
| title_full_unstemmed | Autoimmune and paraneoplastic seizures |
| title_short | Autoimmune and paraneoplastic seizures |
| title_sort | autoimmune and paraneoplastic seizures |
| work_keys_str_mv | AT wagnerb autoimmuneandparaneoplasticseizures AT iranis autoimmuneandparaneoplasticseizures |