NMDA, AMPA and GABA Receptor Antibodies; Relation to Clinical and Electrophysiological Findings in Drug-Resistant Epilepsy

Abstract

pilepsy is a neurological disorder characterized by sudden recurrent episodes of convulsions, sensory disturbance, or loss of consciousness, resulting from abnormal electrical brain activity. According to The International League against Epilepsy, the condition is defined by at least 2 unprovoked seizures more than 24 hours apart. More than 70 million people worldwide are affected by this disorder. Epilepsy can have both genetic and acquired causes, with interaction of these factors in many cases. Acquired causes include severe brain trauma, stroke, tumors and problems in the brain as a result of a previous infection. In about 60% of cases the exact cause is unknown. In addition, auto-antibodies against synaptic receptors have been detected in a number of neurological conditions such as anti-NMDA receptor encephalitis and limbic encephalitis. Anticonvulsant medications are the cornerstone of epilepsy treatment, which may continue for lifetime of the patient. Initially, a single medication is recommended; if control is not achieved, changing to a single other medication is recommended. If the second medication fails, two medications at once are recommended then. Failure of adequate trials of two tolerated and appropriately chosen and used antiepileptic drugs to achieve sustained seizure freedom is known as drug-resistant epilepsy.