Abstracts

RATIONALE: Anticardiolipin antibody (aCL) is reported to be positive in patients with antiphospholipid syndrome. However, aCL has been reported in patients with various CNS disorders. We examined the frequency of aCL in patients with various kind of epilepsy in order to clarify whether aCL is involved in the pathogenesis of childhood epilepsy.
METHODS: Serum samples from 175 epileptic patients and 71 non-epileptic patients were obtained after informed consent. The aCL IgG was measured using an ELISA kit purchased from MBL (Nagoya, Japan). The 175 epileptic patients included 9 with idiopathic generalized epilepsy (IGE), 46 with symptomatic generalized epilepsy (SGE) including 21 with West syndrome, 73 with cryptogenic or symptomatic localization-related epilepsy (C/SLE), 29 with idiopathic localization-related epilepsy, and 18 with unclassified epilepsy.
RESULTS: Although the normal range of this kit is set as below 10 U/ml in adults, we tentatively set the normal range as below 15 U/ml. Consequently, 24 % of epileptic patients and 15% of non-epileptic patients were positive for aCL. There was no significant difference between the two groups. Among epileptic patients, SGE patients were positive significantly more often than C/SLE patients (p = 0.014). When epileptic patients were divided into aCL-positive (42 patients) and aCL-negative (133 patients) groups, there were no significant differences between the two groups in terms of sex, poly-pharmacy, antinuclear antibody, antiDNA antibody, and drugs used for treatment. However, SGE and age less than one year were significantly more frequent in the aCL-positive group (p = 0.014 and [lt]0.0001, respectively). Patients whose seizure type was epileptic spasm including West syndrome were significantly more frequent in the aCL-positive group (p = 0.0001).
CONCLUSIONS: We found that aCL was present in some pediatric patients with epilepsy and other non-epileptic disorders. In all of our cases, CT and MRI showed no evidence of vascular lesions. This suggests that there is a direct cross reaction between aCL and the CNS. There was a significant relationship between aCL and those who had SGE and whose seizure type was epileptic spasm, suggesting that aCL was involved in the pathogenesis of particular type of epilepsy including West syndrome.
[Supported by: Grant-in-Aid from the Ministry of Education, Culture, Science, Technology of Japan]