Lack of antibodies to NMDAR or VGKC-complex in GAD and cardiolipin antibody-positive refractory epilepsy.
BACKGROUND
Over the last few years autoantibodies against neuronal proteins have been identified in several forms of autoimmune encephalitis and epilepsy. NMDA receptor (NMDAR) and voltage gated potassium channel (VGKC) complex antibodies are mainly associated with limbic encephalitis (LE) whereas glutamic acid decarboxylase antibodies (GADA) and anticardiolipin (ACL) antibodies are more commonly detected in patients with chronic epilepsy. Clinical features vary between these antibodies suggesting the specificity of different neuronal antibodies in seizures.


METHODS
Serum samples of 14 GADA positive and 24 ACL positive patients with refractory epilepsy were analyzed for the presence of VGKC or NMDAR antibodies.


RESULTS
No positive VGKC or NMDAR antibodies were found in these patients.


CONCLUSIONS
The results confirm the different significance of these neuronal antibodies in seizure disorders. Different autoantibodies have different significance in seizures and probably have different pathophysiological mechanisms of actions.
Department of Neurosciences and Rehabilitation, Tampere University Hospital, Tampere, Finland; Department of Emergency Medicine, Tampere University Hospital, Tampere, Finland. Electronic address: suvi.liimatainen@fimnet.fi.
Suvi
S
Liimatainen
Department of Neurosciences and Rehabilitation, Tampere University Hospital, Tampere, Finland.
Jukka
J
Peltola
Department of Neurosciences and Rehabilitation, Tampere University Hospital, Tampere, Finland.
Aki
A
Hietaharju
Service of Neurology and Institut d́Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Barcelona, Spain.
Lidia
L
Sabater
Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford OX3 9DS, UK.
Bethan
B
Lang
D000293:Adolescent; D000328:Adult; D000368:Aged; D000906:Antibodies / Q000097:blood*; D002308:Cardiolipins / Q000276:immunology*; D004827:Epilepsy / Q000097:blood* / Q000276:immunology; D005260:Female; D005968:Glutamate Decarboxylase / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009419:Nerve Tissue Proteins; D024642:Potassium Channels, Voltage-Gated / Q000276:immunology*; D016194:Receptors, N-Methyl-D-Aspartate / Q000276:immunology*; D055815:Young Adult
D000906:Antibodies; D002308:Cardiolipins; D009419:Nerve Tissue Proteins; D024642:Potassium Channels, Voltage-Gated; D016194:Receptors, N-Methyl-D-Aspartate; D005968:Glutamate Decarboxylase
Autoimmune encephalitis; Neuronal antibody; New-onset epilepsy; Polyautoimmunity; Refractory epilepsy; Seizure