• Ebru Nur Vanli-Yavuz, Ece Erdag, Erdem Tuzun, Esme Ekizoglu, Leyla Baysal-Kirac, Canan Ulusoy, Sian Peach, Gokcen Gundogdu, Serra Sencer, Altay Sencer, Cem Ismail Kucukali, Nerses Bebek, Candan Gurses, Aysen Gokyigit, and Betul Baykan.
• Istanbul Faculty of Medicine, Departments of Neurology and Clinical Neurophysiology, Istanbul University, Istanbul, Turkey Department of Neurology, Koc University, School of Medicine, Istanbul, Turkey.
• J. Neurol. Neurosurg. Psychiatr. 2016 Jul 1; 87 (7): 684-92.

ObjectiveOur aim was to investigate the prevalence of neuronal autoantibodies (NAbs) in a large consecutive series with mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS) and to elucidate the clinical and laboratory clues for detection of NAbs in this prototype of frequent, drug-resistant epilepsy syndrome.MethodsConsecutive patients diagnosed with MTLE fulfilling the MRI criteria for HS were enrolled. The sera of patients and various control groups (80 subjects) were tested for eight NAbs after ethical approval and signed consents. Brain tissues obtained from surgical specimens were also investigated by immunohistochemical analysis for the presence of inflammatory infiltrates. The features of seropositive versus seronegative groups were compared and binary logistic regression analysis was performed to explore the differentiating variables.ResultsWe found antibodies against antigens, contactin-associated protein-like 2 in 11 patients, uncharacterised voltage-gated potassium channel (VGKC)-complex antigens in four patients, glycine receptor (GLY-R) in 5 patients, N-methyl-d-aspartate receptor in 4 patients and γ-aminobutyric acid receptor A in 1 patient of 111 patients with MTLE-HS and none of the control subjects. The history of status epilepticus, diagnosis of psychosis and positron emission tomography or single-photon emission CT findings in temporal plus extratemporal regions were found significantly more frequently in the seropositive group. Binary logistic regression analysis disclosed that status epilepticus, psychosis and cognitive dysfunction were statistically significant variables to differentiate between the VGKC-complex subgroup versus seronegative group.ConclusionsThis first systematic screening study of various NAbs showed 22.5% seropositivity belonging mostly to VGKC-complex antibodies in a large consecutive series of patients with MTLE-HS. Our results indicated a VGKC-complex autoimmunity-related subgroup in the syndrome of MTLE-HS.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

39 keywords...

hide…