Epilepsy surgery

Epilepsy is autoimmune

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Epilepsy Handbook Return to first page of Epilepsy Functional hemispherectomy-a surgical intervention that disconnects the epileptic areas by removing certain cortical structures-is so far the only recommended therapy for RE patients that are unresponsive to anticonvulsants. Novel and striking support for beneficial immunotherapy of RE was presented such as IVIg , steroids and anti-inflammatory treatments.

After long-term treatments with monthly hIVIg (intravenous human immunoglobulin, 2 g/kg) and an H2 antagonist (histamine receptor 2 antagonist), all eight treated adult RE patients showed significant improvements in function, decreased seizures, SPECT (single photon emission computed tomography), MRI (magnetic resonance imaging) and less inflammation in the CSF. These improvements were maintained for up to 5 years (I. Hart). In addition, selective removal of IgG by protein A immunoadsorption was effective in one RE patient who had detectable antibodies to GluR3; removal caused interruption of status epilepticus on different occasions, reduced seizure frequency and improvement of cognitive functions (C. Antozzi). Finally, plasma exchange or IVIg evoked good responses of patients with epilepsy-associated Hashimoto's or viral encephalitis (B. Lang), in which antibodies to voltage-gated potassium channels were found.

Together, the above findings suggest that epileptic patients should be tested for antibodies, primarily to GluR3. If positive, long-term immunotherapy should be considered before severe brain surgery. Although neurologists may now be required to accept the tantalizing concept that some human epilepsies have an autoimmune basis and treat their patients accordingly, immunologists and neurobiologists will have to continue to expand their studies of autoimmune epilepsy, as probably only the tip of the iceberg has been discovered so far. Causes Make sure you do not have celiac disease

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