Otoimmün Epilepsiler
Özet
Otoimmün epilepsi, bağışıklık sisteminin nöbet patogenezinde aktif rol oynadığı ve geleneksel antiepileptik tedavilere genellikle dirençli olan, ancak immünoterapiye yanıt verebilen bir klinik tablodur. Tanı süreci; subakut başlangıçlı nöbetler, bilişsel gerileme ve psikiyatrik semptomların varlığında BOS analizi, nörolojik görüntüleme, EEG bulguları ve APE2 ile RITE2 gibi klinik skorlama sistemlerinin kullanımıyla desteklenir. Hastalığın yönetiminde erken tanı ve hızlı immünoterapi uygulaması, hem pediatrik hem de erişkin vakalarda daha iyi klinik prognoz elde etmek için kritiktir. Nöronal yüzey ve hücre içi antikorların tespiti, kesin tanı koyma ve hastaya özgü tedavi stratejilerini belirleme aşamasında temel yol göstericidir.
Autoimmune epilepsy is a condition where the immune system plays a direct role in seizure pathogenesis, typically manifesting as drug-resistant seizures that may respond to immunotherapy. Diagnosis is supported by evaluating subacute onset seizures, cognitive decline, and psychiatric symptoms through CSF analysis, neuroimaging, EEG findings, and clinical scoring systems such as APE2 and RITE2. Early recognition and prompt initiation of immunotherapy are critical for achieving improved clinical outcomes in both pediatric and adult patients. Identifying neuronal surface and intracellular antibodies is essential for confirming the diagnosis and determining the appropriate therapeutic strategy.
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