Dokument: Autoimmune-associated epilepsy – a challenging concept

Titel:Autoimmune-associated epilepsy – a challenging concept
URL für Lesezeichen:https://docserv.uni-duesseldorf.de/servlets/DocumentServlet?id=69807
URN (NBN):urn:nbn:de:hbz:061-20250605-110925-9
Kollektion:Publikationen
Sprache:Englisch
Dokumententyp:Wissenschaftliche Texte » Artikel, Aufsatz
Medientyp:Text
Autoren: Melzer, Nico [Autor]
Rosenow, Felix [Autor]
Dateien:
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Dateien vom 05.06.2025 / geändert 05.06.2025
Stichwörter:Autoimmune-associated epilepsy, Focal seizures and epilepsy, Autoimmune (limbic) encephalitis, Data-driven prediction
Beschreibung:The current International League Against Epilepsy (ILAE) definition and classification guidelines for the first time introduced the category of immune-mediated focal epilepsy in addition to structural, genetic, infectious, and metabolic aetiologies. Moreover, the ILAE Autoimmunity and Inflammation Taskforce recently provided a conceptual framework for the distinction between acute “provoked” seizures in the acute phase of autoimmune encephalitis from chronic “unprovoked” seizures due to autoimmune-associated epilepsy. The first category predominately applies to those autoimmune encephalitis patients with autoantibodies against cell surface neural antigens, in whom autoantibodies are assumed to exert a direct ictogenic effect without overt structural damage. These patients do not exhibit enduring predisposition to seizures after the “acute phase” encephalitis, and thus do not fulfil the definition of epilepsy. The second category applies to those autoimmune encephalitis patients with autoantibodies against intracellular neural antigens and Rasmussen's encephalitis, in whom T cells are assumed to cause epileptogenic effects through immune-inflammation and overt structural damage. These patients do exhibit enduring predisposition to seizures after the “acute phase” of encephalitis and thus fulfil the definition of epilepsy. AAE may result from both, ongoing brain autoimmunity and associated structural brain damage according to the current ILAE definition and classification guideline. We here discuss the difficulties of this concept and suggest an unbiased translationally validated and data-driven approach to predict in an individual encephalitis patient the propensity to develop (or not) AAE and the cognitive and behavioural outcome.
Rechtliche Vermerke:Originalveröffentlichung:
Melzer, N., & Rosenow, F. (2024). Autoimmune-associated epilepsy – a challenging concept. Seizure, 128, 20–23. https://doi.org/10.1016/j.seizure.2024.05.017
Lizenz:Creative Commons Lizenzvertrag
Dieses Werk ist lizenziert unter einer Creative Commons Namensnennung 4.0 International Lizenz
Fachbereich / Einrichtung:Medizinische Fakultät
Dokument erstellt am:05.06.2025
Dateien geändert am:05.06.2025
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