title: Neuronal autoantibodies in mesial temporal lobe epilepsy with hippocampal sclerosis.
abstract: Our aim was to investigate the prevalence of neuronal autoantibodies (NAbs) in a large consecutive series with mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS) and to elucidate the clinical and laboratory clues for detection of NAbs in this prototype of frequent, drug-resistant epilepsy syndrome.
  
  
  
  Consecutive patients diagnosed with MTLE fulfilling the MRI criteria for HS were enrolled. The sera of patients and various control groups (80 subjects) were tested for eight NAbs after ethical approval and signed consents. Brain tissues obtained from surgical specimens were also investigated by immunohistochemical analysis for the presence of inflammatory infiltrates. The features of seropositive versus seronegative groups were compared and binary logistic regression analysis was performed to explore the differentiating variables.
  
  
  
  We found antibodies against antigens, contactin-associated protein-like 2 in 11 patients, uncharacterised voltage-gated potassium channel (VGKC)-complex antigens in four patients, glycine receptor (GLY-R) in 5 patients, N-methyl-d-aspartate receptor in 4 patients and γ-aminobutyric acid receptor A in 1 patient of 111 patients with MTLE-HS and none of the control subjects. The history of status epilepticus, diagnosis of psychosis and positron emission tomography or single-photon emission CT findings in temporal plus extratemporal regions were found significantly more frequently in the seropositive group. Binary logistic regression analysis disclosed that status epilepticus, psychosis and cognitive dysfunction were statistically significant variables to differentiate between the VGKC-complex subgroup versus seronegative group.
  
  
  
  This first systematic screening study of various NAbs showed 22.5% seropositivity belonging mostly to VGKC-complex antibodies in a large consecutive series of patients with MTLE-HS. Our results indicated a VGKC-complex autoimmunity-related subgroup in the syndrome of MTLE-HS.
authors.affiliation: Istanbul Faculty of Medicine, Departments of Neurology and Clinical Neurophysiology, Istanbul University, Istanbul, Turkey Department of Neurology, Koc University, School of Medicine, Istanbul, Turkey.
authors.forename: Ebru Nur
authors.initials: EN
authors.lastname: Vanli-Yavuz
authors.affiliation: Department of Neuroscience, Istanbul University, Institute of Experimental Medical Research, Istanbul, Turkey.
authors.forename: Ece
authors.initials: E
authors.lastname: Erdag
authors.affiliation: Department of Neuroscience, Istanbul University, Institute of Experimental Medical Research, Istanbul, Turkey.
authors.forename: Erdem
authors.initials: E
authors.lastname: Tuzun
authors.affiliation: Istanbul Faculty of Medicine, Departments of Neurology and Clinical Neurophysiology, Istanbul University, Istanbul, Turkey Department of Neuroscience, Istanbul University, Institute of Experimental Medical Research, Istanbul, Turkey.
authors.forename: Esme
authors.initials: E
authors.lastname: Ekizoglu
authors.affiliation: Istanbul Faculty of Medicine, Departments of Neurology and Clinical Neurophysiology, Istanbul University, Istanbul, Turkey.
authors.forename: Leyla
authors.initials: L
authors.lastname: Baysal-Kirac
authors.affiliation: Department of Neuroscience, Istanbul University, Institute of Experimental Medical Research, Istanbul, Turkey.
authors.forename: Canan
authors.initials: C
authors.lastname: Ulusoy
authors.affiliation: Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, UK.
authors.forename: Sian
authors.initials: S
authors.lastname: Peach
authors.affiliation: Istanbul Faculty of Medicine, Department of Pathology, Istanbul University, Istanbul, Turkey.
authors.forename: Gokcen
authors.initials: G
authors.lastname: Gundogdu
authors.affiliation: Istanbul Faculty of Medicine, Department of Neuroradiology, Istanbul University, Istanbul, Turkey.
authors.forename: Serra
authors.initials: S
authors.lastname: Sencer
authors.affiliation: Istanbul Faculty of Medicine, Department of Neurosurgery, Istanbul University, Istanbul, Turkey.
authors.forename: Altay
authors.initials: A
authors.lastname: Sencer
authors.affiliation: Department of Neuroscience, Istanbul University, Institute of Experimental Medical Research, Istanbul, Turkey.
authors.forename: Cem Ismail
authors.initials: CI
authors.lastname: Kucukali
authors.affiliation: Istanbul Faculty of Medicine, Departments of Neurology and Clinical Neurophysiology, Istanbul University, Istanbul, Turkey.
authors.forename: Nerses
authors.initials: N
authors.lastname: Bebek
authors.affiliation: Istanbul Faculty of Medicine, Departments of Neurology and Clinical Neurophysiology, Istanbul University, Istanbul, Turkey.
authors.forename: Candan
authors.initials: C
authors.lastname: Gurses
authors.affiliation: Istanbul Faculty of Medicine, Departments of Neurology and Clinical Neurophysiology, Istanbul University, Istanbul, Turkey.
authors.forename: Aysen
authors.initials: A
authors.lastname: Gokyigit
authors.affiliation: Istanbul Faculty of Medicine, Departments of Neurology and Clinical Neurophysiology, Istanbul University, Istanbul, Turkey.
authors.forename: Betul
authors.initials: B
authors.lastname: Baykan
mesh_terms: D000328:Adult; D001323:Autoantibodies / Q000097:blood*; D003072:Cognition Disorders / Q000276:immunology / Q000473:pathology; D003430:Cross-Sectional Studies; D000069279:Drug Resistant Epilepsy / Q000276:immunology* / Q000473:pathology; D004833:Epilepsy, Temporal Lobe / Q000276:immunology* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006624:Hippocampus / Q000276:immunology* / Q000473:pathology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009474:Neurons / Q000276:immunology* / Q000473:pathology; D024642:Potassium Channels, Voltage-Gated / Q000276:immunology*; D011618:Psychotic Disorders / Q000276:immunology / Q000473:pathology; D012016:Reference Values; D012598:Sclerosis / Q000276:immunology / Q000473:pathology; D013226:Status Epilepticus / Q000276:immunology / Q000473:pathology
chemical_list: D001323:Autoantibodies; D024642:Potassium Channels, Voltage-Gated