Status epilepticus with neuron-reactive serum antibodies: Response to plasma exchange

Lousa, M.; Sanchez–Alonso, S.; Rodriguez-Diaz, Rayner; Dalmau, Josep

doi:10.1212/wnl.54.11.2163

Cited by 31 publications

(12 citation statements)

References 11 publications

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“…However, seizure control in two patients with severe complex partial epilepsy with secondary generalization associated with GM1 antibodies improved markedly after IVIG [42]. Recently, one patient in status epilepticus associated with unidentified antineuron antibodies responded to plasma exchange [44]. Recently, one patient in status epilepticus associated with unidentified antineuron antibodies responded to plasma exchange [44].…”

Section: Screening For Antibodies In the General Population Of Epilepmentioning

confidence: 99%

Immunotherapy for epilepsy

Levite¹,

Hart²

2002

Expert Review of Neurotherapeutics

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The study of antibodies to the glutamate AMPA receptor subtype 3 in the pathogenesis of severe epilepsy associated with Rasmussen's encephalitis helped to crystallize the concept of autoimmune epilepsy. This work has been used as a paradigm to investigate autoimmunity, especially the humoral components, in several severe childhood epilepsies and more recently, in some of the more common acquired adult epilepsies. In addition, it helped prompt many open-label trials of immunotherapy for various epilepsies. We discuss the evidence that antiglutamate AMPA receptor subtype 3 antibodies are pathogenic and review the findings of the studies of immunotherapy for epilepsy. We conclude that immune treatments can have useful disease-modifying effects in some rare epilepsies, such as Rasmussen's encephalitis, at least in the short term and that their potential should be studied in the management of some forms of severe adult epilepsy.

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Section: Screening For Antibodies In the General Population Of Epilepmentioning

confidence: 99%

Immunotherapy for epilepsy

Levite¹,

Hart²

2002

Expert Review of Neurotherapeutics

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“…Plasma exchange and protein A immunoadsorption can be useful in refractory status epilepticus because of removing of circulating autoantibodies [24].…”

Section: Treatmentmentioning

confidence: 99%

Eponym

2010

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Rasmussen's syndrome (RS) is a rare acquired progressive inflammatory encephalopathy characterized by drug-resistant partial seizures and cognitive deterioration resulting from a gradual impairment and a subsequent atrophy of a single brain hemisphere. It was firstly described by Theodore Rasmussen in 1958. The original etiopathogenic hypothesis of a chronic viral infection no longer holds. Today, the presumed mechanism is a complex autoimmune process comprising an active role of both cytotoxic T lymphocytes and circulating autoantibodies, activating the subunit 3 of the ionotropic glutamate receptor (GluR3Ab). Several medical options, such as antiepileptic drugs and immunomodulatory therapies, deserve consideration to face epileptic manifestations and to slow neurologic regression. Yet, all these therapies turn out to be almost always just temporizing measures. Surgical disconnection of the affected hemisphere ("functional hemispherectomy") is the best therapeutic choice to achieve the arrest of the disease, a good seizure control, the block of neurologic decline, and the improvement of patient's quality of life.

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“…In addition, the value of immunomodulatory therapies including ACTH, corticosteroids, and to a lesser extent plasmapheresis and IVIG in pediatric epilepsy syndromes such as West syndrome, Lennox-Gastaut, Landau-Kleffner, and Rasmussen encephalitis have been demonstrated by several studies and case series [167][168][169][170][171][172]. With regard to refractory status epilepticus specifically, there are occasional case reports documenting both treatment success and failure with plasmapheresis [173,174]. Given the paucity of evidence, unless an autoimmune etiology is strongly suspected, immunomodulatory therapies should be reserved for refractory status epilepticus only in exceptional circumstances.…”

Section: Status Epilepticusmentioning

confidence: 99%