Description

Autoimmune epilepsy is a type of epilepsy in which seizures are caused by the immune system mistakenly attacks the cells of the brain. May occur with conditions that affect the immune system, especially autoimmune encephalitis.

Autoimmune epilepsy is also known as autoimmune-associated epilepsy and acute symptomatic seizures secondary to autoimmune encephalitis.

The immune system protects the body from viruses, bacteria and other substances that can cause disease. Antibodies are proteins that are part of the immune system. In epilepsy, the antibodies mistakenly directed to the receptors in the brain. This leads to inflammation in the brain, also known as the inflammation, and seizures.

Anti-seizure medications usually don't do enough to control seizures in people with epilepsy autoimmune. In its place, the immunotherapy drugs help to reduce the immune response in the brain.

When immunotherapy is started early, it can reduce inflammation and improve seizures. For some people, treatment can stop the seizures completely. For others, the seizures may continue after treatment.

Symptoms

The symptoms of epilepsy, autoimmune may begin after an illness with a fever. The seizures appear suddenly and are severe. The types of seizures that may occur include:

  • Focal seizures. These are the most common type of seizures in epilepsy. Sometimes with focal seizures cause a change or loss of consciousness. The seizures can cause the person to look at it and not respond to the environment. Other types of focal seizures do not cause a change in consciousness. These attacks cause different symptoms depending on the part of the brain that causes them. Focal seizures can cause a part of the body to tremble. Or can cause a feeling that his has happened before, known as déjà vu. Focal seizures, also can cause nausea or vision symptoms, such as flashing lights.
  • Faciobrachial dystonic seizures. These attacks cause the contractions of the muscles on one side of the face and one arm, both on the same side of the body.

The symptoms related to epilepsy:

  • Seizures that occur several times a day.
  • Attacks that cannot be cured with anti-seizure medications.
  • Seizures that last more than five minutes, or occur together without the person regaining consciousness, known as status epilepticus.

Autoimmune epilepsy symptoms can also include:

  • Memory loss and problems with thinking.
  • Personality and behavior changes.
  • Involuntary movements or awkward movements.
  • Irregular movements of the eye.
  • Changes in heart rate, blood pressure, and other automatic functions.

When to see a doctor

Get emergency medical care if you or someone has a seizure that lasts more than five minutes or if the attacks occur one after the other with a loss of consciousness. Also seek emergency medical attention by high fever and difficulty breathing.

Consult with your healthcare provider right away if you have had a seizure for the first time or if you have other symptoms of epilepsy, autoimmune.

Causes

Autoimmune epilepsy is caused by the immune system attacks the cells in the brain and leads to seizures. Antibodies are part of the immune system. Typically protect the body against viruses and infections. But in autoimmune diseases, the immune system attacks healthy cells. More recently, research has come to the conclusion that epilepsy may be an autoimmune disease.

Autoimmune epilepsy causes may include:

  • Autoimmune encephalitis. Autoimmune encephalitis (en-sef-uh-LIE-tis) is a group of conditions that cause inflammation in the brain. This happens because the immune system mistakenly attacks the cells of the brain. Autoimmune encephalitis causes a variety of symptoms, including seizures. It is the most common cause of epilepsy autoimmune. Certain types of autoimmune encephalitis are commonly linked to autoimmune epilepsy and are associated with antibodies that target NMDA receptors, LGI1, CASPR2 and GAD65.
  • The syndrome Rasmussen. In this condition, the immune cells known as T cells cause inflammation and brain damage that can lead to seizures. People with epilepsy autoimmune due to syndrome of Rasmussen may continue to have seizures after treatment.
  • Cancer. Sometimes, the tumors cause the immune system to attack the healthy cells of the brain, known as paraneoplastic syndrome. This can lead to epilepsy.

Risk factors

The risk of epilepsy autoimmune is low, but can occur in children and adults. The risk factors include:

  • Have another autoimmune disease. These may include rheumatoid arthritis, Graves disease, Hashimoto thyroiditis, Crohn's disease, ulcerative colitis, or lupus.
  • Having a history of cancer.
  • Having a parent, sibling or child with an autoimmune disease.

Complications

Autoimmune epilepsy complications may include severe seizures that last more than five minutes or occur one after the other. The person is not aware between the seizures. These severe attacks which is known as status epilepticus. In need of emergency medical attention.

Sometimes autoimmune epilepsy can lead to seizures that do not stop with the treatment.

Prevention

You may not be able to prevent epilepsy autoimmune. But getting cancer screenings can help your health care professional detect tumors and treated early. This could prevent the autoimmune encephalitis triggered by the cancer, which may be a cause of epilepsy. Talk with your healthcare provider about your risk of cancer and whether you should be tested for detection of certain types of cancer.

Diagnosis

An autoimmune epilepsy diagnosis begins with a physical exam and a review of your symptoms.

Tests for autoimmune epilepsy includes laboratory tests, brain imaging and testing of the electrical activity in the brain.

Laboratory tests

Laboratory tests to see if you have antibodies in the immune system that are attacking the cells of the brain and the cause of the seizures.

Health professionals antibody test for the test of the blood or the fluid that surrounds the brain and spinal cord, known as the cerebrospinal fluid. The cerebrospinal fluid is removed during a procedure known as a lumbar puncture. A health professional will numb the lower part of the back and uses a hollow needle to extract the test fluid.

For some people with epilepsy, autoimmune, these tests do not find antibodies.

Images of the brain

An mri scan of your brain may look for signs of autoimmune diseases of the epilepsy. You can also have a brain imaging test known as fluorodeoxyglucose (FDG) PET. This test checks how well the nutrients are metabolized in the brain. This can provide clues about whether you have certain types of autoimmune encephalitis that may be the cause of the seizures. Brain imaging can also rule out other possible causes of seizures.

EEG

An electroencephalogram is a test that measures the electrical activity in the brain. This test is also called an EEG. It can be shown that seizure activity and may help to diagnose the epilepsy autoimmune. An EEG can also help rule out other conditions. Your health care provider may record the activity of the attacks through a video EEG.

Treatment

Autoimmune treatment of epilepsy differs from the treatment used for other types of epilepsy. The health professionals on the use of immunotherapy to reduce the activity of the immune system and the treatment of seizures.

If cancer is the cause of the epilepsy, autoimmune, for the treatment of cancer is an important part of the treatment.

Immunotherapy

The immunotherapy drugs for epilepsy autoimmune may include:

  • High-dose corticosteroides.Su professional of the health can be treated with methylprednisolone (Solu-Medrol) through an IV in your arm for up to five days. After this period, you can take methylprednisolone INTRAVENOUSLY regularly for weeks, gradually lengthening the time between doses. Or you can take a steroid medicine prednisone oral. Taking a high dose of up to five days, then a lower dose over several weeks. Over time, the dose of the oral medicine is slowly declining. This is known as tapering.
  • The immunoglobulin. This medicine is taken INTRAVENOUSLY in the arm for up to five days. Then you take the smallest dose of the medicine regularly for several weeks.

High doses of corticosteroids. Your health care professional may be treated with methylprednisolone (Solu-Medrol) through an IV in your arm for up to five days. After this period, you can take methylprednisolone INTRAVENOUSLY regularly for weeks, gradually lengthening the time between doses.

Or you can take a steroid medicine prednisone oral. Taking a high dose of up to five days, then a lower dose over several weeks. Over time, the dose of the oral medicine is slowly declining. This is known as tapering.

Depending on your response to treatment, the healthcare professional may also recommend over-acting medications that work on the immune system. These can include rituximab (Rituxan, Truxima, others), cyclophosphamide, mycophenolate (Cellcept, Myhibbin), azathioprine (Azasan, Imuran), or tocilizumab (Actemra, Tofidence, Tyenne).

Plasma exchange

Your healthcare provider may also recommend plasma exchange. A health care professional, you remove the liquid part of the blood and separates it from your blood cells. Then, the blood cells are put back in your body and your body makes more of plasma. This therapy helps to eliminate the antibodies that are causing the immune system to attack the cells of the brain.

Anti-seizure medications

Although the anti-seizure medications don't work as well in people with epilepsy, autoimmune, they can still play a role in the treatment. However, the effectiveness of these medicines may be limited. If you take the immunotherapy and become free of seizures, your healthcare provider may suggest to slowly reduce the dose of anti-seizure medications for several months to see if the attacks of return.

Many people whose seizures are due to the autoimmune encephalitis become free of seizures after taking the immunotherapy. It may take several months after treatment for the seizures to stop. But the attacks continued for some people, even after the immunotherapy. People with GAD65 antibodies are less likely to become seizure-free.

If you have other symptoms of seizures, such as problems with memory or speech, you may need rehabilitation. Occupational and speech therapy can help.

Surgeries

The syndrome Rasmussen, that mainly affects children, usually do not respond to medication. Brain surgery is often necessary to treat this type of autoimmune disease of epilepsy.

Preparing for your appointment

If your symptoms are severe, you might need emergency medical attention.

If their symptoms are not so severe, you can start by seeing your health care professional. Or you may be referred immediately to a doctor who specializes in diseases of the nervous system, known as a neurologist.

What you can do

When you make the appointment, ask if there is something that you need to do in advance, such as fasting before a specific test. Make a list of:

  • Your symptoms, including any that seem unrelated to the reason for your appointment.
  • Key personal information, including major stresses, recent life changes and family medical history.
  • All medications, vitamins or supplements that you are taking, including the dosage.
  • Questions to ask your health care professional.

Have a friend or family member, if possible, to help you remember the information they give you.

For autoimmune epilepsy, some basic questions to ask include:

  • What is likely causing my symptoms?
  • Other that the most likely cause, what are other possible causes of the symptoms?
  • What tests do I need?
  • Is my condition likely to be short-term or duration?
  • What is the best course of action?
  • What are the alternatives to the primary approach you're suggesting?
  • I have these other health conditions. How can I best manage them together?
  • There are restrictions that must be followed?
  • You should see a specialist?
  • Are there brochures or other printed material I can have? What sites do you recommend?

Do not hesitate to ask other questions.

What to expect from your doctor

Your healthcare provider is likely to ask several questions, such as:

  • When did your symptoms begin?
  • Do your symptoms occur all the time or intermittently?
  • How bad are the symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
Symptoms and treatment of epilepsy Autoimmune