Brain and nerve = Shinkei kenkyū no shinpo
-
The recent discovery of autoimmune antibodies to the neuronal cell surface membrane and extra- or intra-cellular proteins, such as NMDAR and LGI1, shed light on a proposed new etiology of epilepsy, namely, "autoimmune epilepsy". A large part of this entity most likely belongs to a forme fruste of autoimmune (limbic) encephalitis. Seizures are usually subacute in onset and refractory to antiepileptic medications. ⋯ Early intensive immunotherapy could cure seizures and prevent the full-blown clinical manifestation of encephalitis. Some patients present with relatively mild clinical symptoms and/or MRI findings, and can have a smoldering course lasting years. Establishment of the biomarkers of the ongoing CNS inflammation, especially for the smoldering and the suspected autoantibody-negative cases, is warranted for tailored immunotherapy for both the subacute and chronic phases of the disease.