% 0期刊文章%一个森昭熙泰汇吴作栋% %的伦纳德梁Litt Yeo %的鸿沟拉胡尔Rathakrishnan % T:裁剪一个方法治疗发热性感染相关的癫痫综合征% D R 10.1212 / WNL 2023%。0000000000207068 % J半岛投注体育官网神经病学% P 1151 - 1155 V % 100% N 24% X细胞因子分析之前在发热性感染所致免疫治疗越来越普遍相关的癫痫综合征(火灾)。在这种情况下,一名18岁男子提出来美最初发作后特异性的发热性疾病。他开发了super-refractory癫痫持续状态需要多个抗癫痫药物和麻醉注入。他接受脉冲甲基强的松龙和血浆置换和生酮饮食开始。对比增强磁共振成像大脑显示postictal变化。脑电图结果显示多病灶的猝发的运行和广义周期痫性放电。CSF分析,自身抗体测试和恶性肿瘤筛查稀松平常的。不确定意义的基因测试显示变异CNKSR2和OPN1LW基因。最初的血清和CSF细胞因子分析进行天6 - 21日透露,白介素6 (IL) IL-1RA,单核细胞化学引诱物蛋白1,巨噬细胞炎性蛋白1β,和干扰素γ升高主要在中枢神经系统,一个概要文件与细胞因子释放综合征一致。Tofacitinib最初入学试着在30天。 There was no clinical improvement, and IL-6 continued to rise. Tocilizumab was given on day 51 with significant clinical and electrographic response. Anakinra was subsequently trialed from days 99 to 103 because clinical ictal activity re-emerged on weaning anesthetics but stopped because of poor response. Serial cytokine profiles showed improvement after 7 doses of tocilizumab. There was corresponding improved seizure control. This case illustrates how personalized immunomonitoring may be helpful in cases of FIRES, where proinflammatory cytokines are postulated to act in epileptogenesis. There is an emerging role for cytokine profiling and close collaboration with immunologists for the treatment of FIRES. The use of tocilizumab may be considered in patients with FIRES with upregulated IL-6. %U //www.ebmtp.com/content/neurology/100/24/1151.full.pdf