Aktuelle Neurologie 2008; 35(5): 214-224
DOI: 10.1055/s-2008-1067419
Übersicht

© Georg Thieme Verlag KG Stuttgart · New York

Chronische Enzephalitiden als Epilepsieursachen: Pathogenese, Diagnostik und Therapie

Chronic Encephalitides as Causes of Epilepsy: Pathogenesis, Diagnosis and TreatmentC.  G.  Bien1
  • 1Universität Bonn, Klinik und Poliklinik für Epileptologie, Bonn
Further Information

Publication History

Publication Date:
03 June 2008 (online)

Zusammenfassung

Die folgenden entzündlich bedingten Hirnerkrankungen ohne (ersichtlichen) infektiösen Ursprung gehen häufig mit fokalen epileptischen Anfällen einher: die Rasmussen-Enzephalitis (RE), die limbische Enzephalitis (LE), die anti-N-Methyl-D-Aspartat(NMDA)-Rezeptor-Enzephalitis und die steroidresponsive Enzephalopathie mit assoziierter Autoimmunthyroiditis (SREAT, früher „Hashimoto-Enzephalopathie”). In den letzten Jahren etablieren sich pathogenetische Konzepte und diagnostische Kriterien für diese Störungen und Syndrome. Es besteht noch keine belastbare Evidenz hinsichtlich der zu bevorzugenden Therapie. Allerdings können aus Fallstudien und aus pathogenetisch basierten Überlegungen begründete Therapieempfehlungen für diese beeinträchtigenden Erkrankungen abgeleitet werden.

Abstract

The following inflammatory brain disorders without (apparent) infectious origin are frequently associated with focal epileptic seizures: Rasmussen's encephalitis (RE), limbic encephalitis (LE), anti-N-methyl-D-aspartate (NMDA) receptor encephalitis, and steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT, formerly called „Hashimoto's encephalopathy”). Pathogenetic concepts and diagnostic criteria for these disorders and syndromes are emerging. However, there is still no reliable evidence regarding the best possible therapy. In this situation, recommendations can only be derived from case studies and from pathogenetic considerations.

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1 Referenzlabore in Deutschland: Institut für Klinische Chemie, Universität Köln, Kerpener Str. 62, 50924 Köln, Tel. 0221/478-5290, http://www.medizin.uni-koeln.de/kppk/paraneoplasie.shtml (Kosten: ca. 150 €) sowie Institut für Klinische Chemie, Ludwig-Maximilians-Universität München, Marchioninistr. 15, 81377 München, http://www.w-klch.med.uni-muenchen.de/klch/ - Für beide Labors gilt, dass ein Serumröhrchen mit regulärer Post ohne besondere weitere Konservierungsmaßnahmen einzusenden ist. Begleitend sollte ein Anforderungsschein mitgeschickt werden, der über die genannten Webseiten heruntergeladen werden kann.

2 Referenzlabor: Prof. Dr. Angela Vincent, Neurosciences Group, Department of Clinical Neurology, Institute of Molecular Medicine, John Radcliffe Hospital, Oxford OX3 9DS, Great Britain. Ein Serumröhrchen - mit kurzem Begleitschreiben mit der Fragestellung - mit regulärer Post ohne besondere weitere Konservierungsmaßnahmen einsenden. Die Kosten für die Untersuchung betragen ca. 50 €..

3 Dieser Test wird z. Z. im Rahmen wissenschaftlicher Untersuchungen in unserem Labor durchgeführt, Adresse des Verfassers. Es werden benötigt: Serum und Liquor mit kurzem Anschreiben mit klinischen Daten und Mitteilung von Serum- und Liquorkonzentrationen für Albumin und IgG.

4 Stehen noch nicht für die klinische Routine zur Verfügung.

5 Test ist an vielen Labors etabliert.

PD Dr. Christian G. Bien

Universität Bonn, Klinik und Poliklinik für Epileptologie

Sigmund-Freud-Straße 25

53105 Bonn

Email: christian.bien@ukb.uni-bonn.de

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