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Chapter 83 - Inflammatory and immunological diseases of the nervous system

from Section 3 - Symptomatic epilepsy

Published online by Cambridge University Press:  05 March 2012

Simon D. Shorvon
Affiliation:
National Hospital for Neurology and Neurosurgery, London
Frederick Andermann
Affiliation:
Montreal Neurological Hospital and Institute
Renzo Guerrini
Affiliation:
Child Neurology Unit, Meyer Pediatric Hospital, Florence
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Summary

This chapter talks about Hashimoto encephalopathy and the treatment-responsive encephalopathies associated with antibodies to neuronal antigens. Epilepsy has also been associated with the inflammatory bowel diseases (ulcerative colitis, Crohn disease, and celiac disease), although this association is more contentious. The chapter discusses the clinical features and treatment options for limbic encephalitis (LE) and the association of LE with epilepsy. Hu/ANNA-1, Ma-2, collapsin-response-mediator protein, amphiphysin and glutamic acid decarboxylase are intracellular antigens associated with LE. Voltage-gated potassium channels, N-methyl-D-aspartate receptor are extracellular antigens associated with LE. Accepted medical treatments for surface-antigen-related LE are high-dose steroids, plasma exchange, and/or intravenous immunoglobulin (IVIG), which are sometimes given in combination. The index disease for autoimmune thyroiditis group of immune-mediated epilepsy syndromes is the entity known as Hashimoto encephalopathy or steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT). The chapter also discusses the management of inflammatory bowel disease (IBD) and SREAT.
Type
Chapter
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The Causes of Epilepsy
Common and Uncommon Causes in Adults and Children
, pp. 585 - 592
Publisher: Cambridge University Press
Print publication year: 2011

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