|NEURAL AUTOANTIBODIES AND IMMUNOTHERAPY-RESPONSIVE EPILEPSY: A PROSPECTIVE STUDY|| |
|R. Iorio1, G. Assenza2, G. Della Marca1, G. Colicchio1, M. Tombini2, V. Damato1, A. Benvenga2, A. Evoli1, D. Plantone1, A. Marti1, C. Vollono1, G. Frisullo1, A.P. Batocchi1|
|1Catholic University, 2Campus Bio-Medico University, Roma, Italy|
specific for neural antigens have been described in association with several
encephalopathies which have seizures as a prominent feature. In these cases seizures
are poorly controlled with conventional anti-epileptic drugs (AED). In contrast,
a good response is often achieved with immunotherapies.|
To evaluate the frequency of autoantibodies specific
to neural antigens in patients with epilepsy and their response to the
Two groups of patients were included in the study: 29 patients with
epilepsy and other neurological symptoms and/or autoimmune diseases (group 1)
and 30 patients with AED-resistant epilepsy (group 2). Forty-two age and
sex-matched healthy subjects (HS) were included as controls.
Patients' Serum and CSF, when
available, were evaluated for the presence of neural autoantibodies by
immunohistochemistry on frozen sections of mouse brain and by cell-based assays.
GAD65-IgGs were tested by RIA.
autoantibodies were detected in 11/59 patients (19%) but not in healthy
controls. In particular, neural-specific
IgGs were detected in two patients from group 1 (2/29, 7%) (anti-GAD65, 1; antibody
specific for an unclassified intracellular antigen [AUIA], 1) and in nine
patients from group 2 (9/29, 31%) (anti-LGI1, 2; anti-GAD65, 1; AUIA, 4; antibody
specific for an unclassified synaptic antigen, 2). In Four patients from group
2, immunotherapy resulted in >50% seizure reduction at three months.
significant percentage of patients with AED-resistant epilepsy harbor
neural-specific autoantibodies and may respond to immunotherapy.
Dr. Raffaele Iorio, Catholic University , Roma , Italy
Assigned in sessions:
22.09.2013, 09:00-10:30, Free Papers, FP1, Free Papers Session 1:
Epilepsy, Hall G