Year: 2013
Type: dissertation
Study design: Observational Study
Abstract: The role of immune mediated mechanisms is increasingly recognised in patients with seizures and epilepsies. Recently the term "autoimmune epilepsy" has been used to imply involvement of the adaptive immune system (particularly humoral) in the pathogenesis of epilepsy. Specific neuronal antibodies against cell surface proteins as well as some intracellular antigens are now recognised in a proportion of adult patients with seizures. The seizures are often severe and not isolated, but rather accompanied by encephalopathy or other neurologic symptoms. Evidence of brain inflammation might be found in cerebrospinal fluid or imaging. The best recognised disorders are limbic encephalitis (associated with antibodies against many neuronal antigens such as VGKC-complex proteins and GAD), and NMDAR encephalitis. However neuronal antibodies are also found in some adult patients with seizures and epilepsies in the absence of encephalopathy or other features. My PhD project aimed to study and investigate neuronal antibodies in children with seizures. This study hoped to help identify children who may have ‘autoimmune seizures and epilepsies’. The studies conducted as part of this thesis found VGKC-complex antibodies in 4 of 10 patients with unexplained encephalitis. Furthermore neuronal antibodies were found in 11 of 114 children with new onset seizures mainly those with epilepsy of unknown cause (predominantly focal). Neuronal antibodies were also found in 7 of 13 patients who had suspected autoimmune epilepsy. The findings in these studies are novel and have shed some light into the importance of neuronal antibodies in paediatric seizures. While the pathogenic role of these antibodies remains a hot topic for debates and future studies, we think that the presence of these antibodies define a group of patients where immune mechanisms are important, and where immunotherapy might improve the clinical outcome.
Author: Jehan Suleiman
Language: Finnish
Subfield: Clinical Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: green
Funders: Alexander and Margaret Stewart Trust, Pfizer, Baxter International, Biogen, Wellcome Trust, Star Scientific Foundation, National Institute for Health and Care Research, Epilepsy Research UK, European Commission, Sir Halley Stewart Trust, Petre Foundation, Medical Research Council, National Health and Medical Research Council, NIHR Oxford Biomedical Research Centre
OpenAlex ID: W611800210