正确认识自身免疫性癫痫与自身免疫性脑炎的关系

自身免疫性癫痫与自身免疫性脑炎均是近年来随着神经免疫学发展而提出的临床新概念。对于伴有癫痫样发作、抗神经元抗体阳性的患者,诊断为自身免疫性脑炎还是自身免疫性癫痫,目前还存在争议和误区。由于二者存在部分共同的抗神经元抗体,且临床表现有一定重叠性,如癫痫的耐药性、合并认知功能损害等,常被临床所混淆,造成了不必要的过度抗癫痫治疗。笔者从二者临床概念、流行病学、发病机制及相关危险因素、临床表现、辅助检查、治疗和预后对二者区别和联系进行了释义。

Correctly understanding the relationship between autoimmune epilepsy and autoimmune encephalitis

Both autoimmune epilepsy and autoimmune encephalitis are new clinical concepts proposed in recent years with the development of neuroimmunology.Is it appropriate for the patients with new-onset epileptic seizures and positive neuron antibodies diagnosed as autoimmune encephalitis or autoimmune epilepsy?There are still disputes and misunderstandings.Because there are usually some common anti-neuronal antibodies detected in the serum or cerebrospinal fluid of them both,and additionally their clinical manifestations have certain overlaps,such as drug resistant epilepsy and cognitive impairment,both concepts are often confused in clinical practice,resulting in unnecessary excessive long-term anti-epileptic treatment.This review interprets the differences and connections between the two diseases on concepts,epidemiology,pathogenesis and related risk factors,clinical manifestations,auxiliary examination,treatment and prognosis.