Otoimmün Epilepsilerin Tedavisi
Özet
Otoimmün epilepsi, otoimmün reaksiyonlar aracılığıyla meydana gelen epilepsi türleridir. Epileptik nöbetlerin yanı sıra 3 ay içinde başlayan, hızlı ilerleyen bilişsel bozukluklar, hareket bozukluklarıyla ilişkili fenomenler, psikiyatrik bozukluklar ve otonom semptomlar da otoimmün epilepside görülebilir. Otoimmün epilepsi şüphesi bulunan hastalarda ayrıntılı anamnez, fiziksel ve nörolojik muayenenin yanı sıra üre, kreatinin, karaciğer ve böbrek fonksiyon testleri, elektrolitler, hemogram, sedimentasyon, C-reaktif protein (CRP) kontrastlı kranial manyetik rezonans görüntüleme (MRG), rutin elektroensefalogram (EEG) gibi tetkikler yapılır. Seropozitif ya da seronegatif olan otoimmün epilepsilerde tedavi, asıl olarak antinöbet tedavisi, diğer semptomların tedavisi, immünoterapidir. Dirençli vakalarda, cerrahi tedavi, nöromodülasyon ve ketojenik diyet de uygulanabilir. Tedaviye hasta bazında karar verilmeli ve yakın izlem ihmal edilmemelidir.
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