title: Antithyroid antibodies as a potential marker of autoimmune-mediated late onset temporal lobe epilepsy.
abstract: In one third of patients with epilepsy starting in adulthood the aetiology remains undetermined. Some patients with late onset temporal lobe epilepsy (TLE) together with memory decline have elevated antithyroid antibodies.
  
  
  OBJECTIVE
  To compare the prevalence of antithyroid antibodies (aTR-ab) in adult onset temporal lobe epilepsy (TLE) patients with known and unknown TLE aetiology (N=42). Moreover, the sera of these patients was also assayed for antinuclear antibodies (ANA), anticardiolipin antibodies (ACL), anti glutamic acid decarboxylase antibodies (GAD) and antiglidadin antibodies.
  
  
  RESULTS
  Positive aTR-ab in the sera of patients with unknown aetiology was 11/23 (47.8%) vs. 1/19 (4.3%) in the group with known aetiology (p=0.005). In 9/11 (81%) a pre-existing autoimmune disease was confirmed. Nine (81%) were women and five (45%) had memory impairment. There were 5/11 (45%) pharmacoresistant patients, and corticosteroid treatment was initiated in 3/5 with cognitive and seizure improvement. The results of other immunological tests were only remarkable for antiGAD antibodies with 3/11 (27%) positive patients, but this subgroup does not have any significant clinical differential feature.
  
  
  CONCLUSIONS
  Late-onset TLE with positive aTR-ab tends to be middle-aged women with nonpharmacoresistant cryptogenic epilepsy plus cognitive decline and other associated autoimmune diseases. It could be advisable to test aTR-ab in TLE patients with an unknown aetiology, in order to improve diagnosis and resulting treatment.
authors.affiliation: Epilepsy Unit, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain; Cognition and Brain Plasticity Group [Bellvitge Biomedical Research Institute] IDIBELL, Barcelona, Spain. Electronic address: jmiro@bellvitgehospital.cat.
authors.forename: Júlia
authors.initials: J
authors.lastname: Miró
authors.affiliation: Neuropsychology Unit, Neurology Service, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain.
authors.forename: Rosa
authors.initials: R
authors.lastname: Fortuny
authors.affiliation: Epilepsy Unit, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain; Cognition and Brain Plasticity Group [Bellvitge Biomedical Research Institute] IDIBELL, Barcelona, Spain; Neuropsychology Unit, Neurology Service, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Juncadella
authors.affiliation: Epilepsy Unit, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain.
authors.forename: Maria
authors.initials: M
authors.lastname: Aiguabella
authors.affiliation: Epilepsy Unit, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain.
authors.forename: Misericòrida
authors.initials: M
authors.lastname: Veciana
authors.affiliation: Epilepsy Unit, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain; IDI, Magnetic Resonance Unit, Institut Diagnostic per la Imatge, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain.
authors.forename: Sara
authors.initials: S
authors.lastname: Castañer
authors.affiliation: Epilepsy Unit, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain.
authors.forename: Mila
authors.initials: M
authors.lastname: Santurino
authors.affiliation: Epilepsy Unit, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain; Cognition and Brain Plasticity Group [Bellvitge Biomedical Research Institute] IDIBELL, Barcelona, Spain.
authors.forename: Mercè
authors.initials: M
authors.lastname: Falip
mesh_terms: D000328:Adult; D000368:Aged; D000906:Antibodies / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D001921:Brain / Q000276:immunology; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis* / Q000209:etiology / Q000276:immunology; D005260:Female; D005968:Glutamate Decarboxylase / Q000276:immunology*; D006801:Humans; D008297:Male; D008568:Memory / Q000502:physiology; D008569:Memory Disorders / Q000175:diagnosis / Q000276:immunology; D008875:Middle Aged; D013961:Thyroid Gland / Q000276:immunology*; D016896:Treatment Outcome
chemical_list: D000906:Antibodies; D015415:Biomarkers; D005968:Glutamate Decarboxylase
keywords: Antithyroid antibodies; Autoimmune disease; Corticotherapy; Epilepsy; Immunological profile