Seizure Threshold in Juvenile Myoclonic Epilepsy with Graves Disease

Su, Yu-Hsien; Izumi, Tatsuro; Kitsu, Megumi; Fukuyama, Yukio

doi:10.1111/j.1528-1157.1993.tb02589.x

Cited by 28 publications

(17 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Graves' disease is an antibody mediated autoimmune disorder and juvenile myoclonic epilepsy (JME) has been previously associated with Grave's disease, and may be due to thyroxine causing a lower seizure threshold (Su et al., ). Our case 11 was diagnosed to have an idiopathic myoclonic epilepsy (JME) based on her age, seizure phenotype, and EEG abnormality.…”

Section: Discussionmentioning

confidence: 99%

Autoimmune epilepsy in children: Case series and proposed guidelines for identification

et al. 2013

View full text Add to dashboard Cite

Summary Purpose Antibodies against neuronal surface proteins are increasingly recognized in autoimmune central nervous system (CNS) disorders in which seizures are the main or an important feature. The disorders include antibody‐associated limbic encephalitis and N‐methyl‐D‐aspartate receptor (NMDAR)encephalitis; however, seizures of autoimmune etiology may exist beyond the spectrum of these recognized syndromes. Because these seizures are potentially treatable with immune therapy, guidelines are needed to help in their early recognition. Methods We describe 13 representative children seen at our tertiary institution over a period of 3.5 years with suspected autoimmune epilepsy. Autoimmune epilepsy was suspected clinically when there was any of the following: (1) recognizable syndromes such as NMDAR encephalitis or limbic encephalitis, (2) evidence of CNS inflammation in cerebrospinal fluid or on magnetic resonance imaging (MRI), (3) the presence of other autoimmune diseases, or (4) positive response to immunotherapy. We tested these patients for neuronal surface antibodies (voltage gated potassium channel [VGKC]‐complex, leucine rich glioma inactivated 1 [LGI1], contactin‐associated protein‐like 2 [CASPR2], and NMDAR) and glutamic acid decarboxylase (GAD) antibodies. We modified the J Neurol Neurosurg Psychiatry, 83, 2012, 638 guidelines that were designed to classify adults with neuronal surface antibody syndromes (NSAS), to be more appropriate for children with suspected autoimmune epilepsy. Using the modified guidelines, the 13 patients were classified into definite, probable, possible, unlikely, or unknown autoimmune epilepsy according to the presence of neuronal surface or GAD antibodies, and the response to immune therapy when given. Key Findings Of the 13 patients, 11 were females, and the mean age was 6 years (range 1–13 years). Three patients had classical NMDAR encephalitis, two had VGKC encephalitis, two had limbic encephalitis with negative antibodies, three had epilepsy with other autoimmune diseases (one with high titer GAD antibodies), two had fever‐induced refractory epileptic encephalopathy in school‐aged children (FIRES), and one epileptic encephalopathy associated with VGKC antibodies. Seven patients of the 13 children with suspected autoimmune epilepsy were positive for neuronal surface antibodies (NMDAR, n = 3; VGKC‐complex, n = 3; and GAD, n = 1). Immunotherapy was given to nine cases, and a positive response was more common in patients with positive neuronal surface antibodies (5/5) compared to those with negative antibodies (2/4). Applying the proposed guidelines, the classification of autoimmune epilepsy was definite in five, probable in one, possible in three, unlikely in two, and unknown in two patients. Significance Neuronal surface antibodies and GAD antibodies are present in a proportion of children with suspected autoimmune epilepsy and may define a treatable subgroup of childhood epilepsy. The proposed guidelines can be useful in the recognition of children with seizures of autoim...

show abstract

Section: Discussionmentioning

confidence: 99%

Autoimmune epilepsy in children: Case series and proposed guidelines for identification

et al. 2013

View full text Add to dashboard Cite

show abstract

“…Hyperthroidism can exacerbate seizures and paroxysmal EEG abnormalities in patients with a diagnosis of epilepsy [390,400] or focal/generalized seizures only during thyrotoxicosis in patients without established epilepsy [401]. The mechanisms of seizure induction by thyroid hormones are not clear, but there are some possible explanations.…”

Section: Convulsionmentioning

confidence: 99%

Complications of Hyperthyroidism

Sayin¹,

Ertek²,

Cesur³

2014

Thyroid Disorders - Focus on Hyperthyroidism

View full text Add to dashboard Cite

“…In Einzelfällen kam es bei rezidivierender Hyperthyreose jeweils auch zum Rezidiv der Anfälle [19]. Bei Patienten mit juveniler myoklonischer Epilepsie (JME) sind besonders Verschlechterungen der Anfallsfrequenz aber auch der Anfallsstärke gut dokumentiert [23,30]. Auch bei fokaler Epilepsie wurde über eine Zunahme komplex partieller Anfälle berichtet [33].…”

Section: Schilddrüse N Hyperthyreose Und Thyroxinintoxikationunclassified

Schilddrüse, Nebenschilddrüse und Epilepsie

Rosenow

Reis

2006

Z. Epileptol.

View full text Add to dashboard Cite

Thyroid, parathyroid glands and epilepsy" Abstract There is clinical evidence that endogenous (hyperthyroidism) as well as exogenous thyroxin intoxications can provoke seizures or increase seizure frequency and intensity. The latter was reported particularly for juvenile myoclonic epilepsy (JME). Hypothyroidism, on the other hand, is associated with a decreased incidence of febrile seizures. Hashimoto-encephalopathy occurs in patients with Hashimoto-thyroiditis and is a usually steroid responsive, at times spontaneously remitting, encephalopathy. Epileptic seizures occurring in 50-60%, myoclonus psychotic or confusional states and changes in the level of consciousness are frequent neuro-psychiatric symptoms. Hypoparathyroidism, usually of iatrogenic etiology, frequently presents with tetany occurring within days or weeks of the operation. However, epileptic seizures were reported in 25-30% of the cases and can emerge months to years after the operation.

show abstract

Seizure Threshold in Juvenile Myoclonic Epilepsy with Graves Disease

Cited by 28 publications

References 15 publications

Autoimmune epilepsy in children: Case series and proposed guidelines for identification

Autoimmune epilepsy in children: Case series and proposed guidelines for identification

Complications of Hyperthyroidism

Schilddrüse, Nebenschilddrüse und Epilepsie

Contact Info

Product

Resources

About