文献综述

儿童自身免疫性癫痫研究进展

  • 张智杰 ,
  • 徐丹凤 ,
  • 李玲
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  • 上海交通大学医学院附属新华医院儿神经内科(上海 200092)

收稿日期: 2024-04-16

  录用日期: 2024-08-19

  网络出版日期: 2025-05-09

Progress in pediatric autoimmune epilepsy

  • ZHANG Zhijie ,
  • XU Danfeng ,
  • LI Ling
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  • Department of Neurology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China

Received date: 2024-04-16

  Accepted date: 2024-08-19

  Online published: 2025-05-09

摘要

近几十年来,随着多种神经元抗体的发现以及对免疫介导各种综合征的发病机制认识的不断提高,自身免疫性癫痫领域有了巨大进步。相当一部分病因不明的癫痫患者已被证实是由自身免疫引起的。儿童自身免疫性癫痫多继发于自身免疫性脑炎,其临床表现多样,以癫痫发作为首要症状,多合并有认知功能障碍、睡眠障碍、言语障碍以及神经精神症状。诊断通常基于临床特征、核磁共振成像结果和脑脊液分析,神经特异性抗体检测是诊断的重要组成部分。治疗方法包括免疫治疗、去除免疫诱因(如肿瘤)以及抗癫痫发作药物等对症治疗。早期启动免疫治疗可有效控制癫痫发作频率并改善认知能力。

本文引用格式

张智杰 , 徐丹凤 , 李玲 . 儿童自身免疫性癫痫研究进展[J]. 临床儿科杂志, 2025 , 43(5) : 395 -402 . DOI: 10.12372/jcp.2025.24e0352

Abstract

The field of autoimmune epilepsy has progressed tremendously in recent decades with the discovery of a wide range of neuronal antibodies and the increasing understanding of the pathogenesis of various immune-mediated syndromes. A significant proportion of patients with epilepsy of unknown etiology have been shown to be caused by autoimmunity. Pediatric autoimmune epilepsy is often secondary to autoimmune encephalitis. Its clinical manifestations are diverse, with seizures being the primary symptom. It is frequently accompanied by cognitive impairment, sleep disturbances, speech disorders, and neuropsychiatric symptoms. Diagnosis is usually based on clinical features, MRI findings, and cerebrospinal fluid analysis, and testing for neurospecific antibodies is an important part of the diagnosis. Treatment includes immunotherapy, removal of immune triggers and symptomatic treatment with antiepileptic drugs. Early initiation of immunotherapy can be effective in controlling seizure frequency and improving cognition.

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