| Abstract [eng] |
Autoimmune etiology is found in about ten percent of epilepsy cases. Autoimmune epilepsy is characterized by specific clinical manifestations, and in order to establish diagnosis, cerebrospinal fluid analysis, neuroimaging tests such as magnetic resonance tomography, and the search for specific antibodies are usually prescribed. Over the years, a great deal of knowledge has emerged about specific autoantibodies against neuronal antigens. Their identification not only helps to diagnose autoimmune epilepsy, but also adjusts the further strategy of treatment, can help to identify concomitant diseases, for example, paraneoplastic disorders. Regardless of diagnostic methods, clinicians are often not able to specify the etiology or antibody type, but it is very important to start empiric immunotherapy as soon as possible if autoimmune epilepsy or autoimmune encephalitis with seizures is suspected. Its administration can significantly change the outcome, reducing the risk of relapses and residual neurocognitive deficits. Immunotherapy is the main treatment choice, which consists of corticosteroids, intravenous immunoglobulin and plasma exchange. If the effect is not sufficient, second-line immunotherapy is prescribed. However, sometimes even after applying immunosuppression, the required effect is not achieved - then alternative or maintenance treatment should be sought. |
