与立体EEG相关的抗GAD65自身免疫脑炎 - - 两例病例的报告
Claude Steriade1,2, Andrew Christiana1, Giovanna Dane1
1New York University Comprehensive Epilepsy Center, 223 E34th St, New York, NY 10016, USA.
Epilepsy & behavior reports
|November 11, 2025
概括
我们报告了两个成人发作叶 (TLE) 的病例,在立体EEG (SEEG) 后发生脑病变. 发现了内GAD抗体合成,这表明自身免疫链接可能是由神经外科手术触发的.
科学领域:
- 神经学 神经学
- 免疫学 免疫学 免疫学
- 神经外科 神经外科
背景情况:
- 成年开始的叶 (TLE) 带来了诊断上的挑战.
- 立体EEG (SEEG) 是一种针对耐火性的侵入性诊断程序.
- 自身免疫性脑炎是神经功能障碍的一个新出现的原因.
研究的目的:
- 为了研究TLE患者经历手术后并发症的潜在自身免疫触发因素.
- 探索GAD抗体在SEEG后的TLE中的作用.
- 突出了手术前自身免疫查的重要性.
主要方法:
- 介绍了两个成人TLE病例.
- 立体电脑脑电图 (SEEG) 植入和随后的扩展.
- 对GAD抗体的血清和脑脊液 (CSF) 分析.
- 评估内抗体的合成.
- 免疫治疗反应的评估.
主要成果:
- 这两名患者在SEEG后都出现了亚急性脑病变和发作恶化.
- 在血清中检测到低位的GAD抗体.
- 证据证实了内GAD抗体合成的证据.
- 一名患者在免疫治疗后出现了临床改善.
结论:
- 像SEEG这样的神经外科手术可能会破坏血脑屏障,可能引发自身免疫反应.
- 在外科手术后的TLE患者中,可以发生内GAD抗体合成.
- 在侵袭性手术之前,应考虑在未知病因的中,特别是具有暗示性表型的自身免疫性.
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