139 KB57 KB199420252020Krajnc, NikSavšek, Linaštevilka:4letnik:59str. 443-458ISSN:0025-8121COBISSID:52757763URN:URN:NBN:SI:doc-RACA8EUOslMedicinski razglediMedicinski razglediavtoimunske motnjeimunoterapijamotnje gibanjaAvtoimunske motnje gibanja| Autoimmune movement disorders|Autoimmune movement disorders present a rare group of diseases which evolve as an exaggregated immune response to neuronal antigens. Patophysiological classification divides them into disorders related to antibodies against intracellular antigens, which are frequently paraneoplastic and have a poor response to immunotherapy, and disorders related to antibodies against neuronal-surface antigens, which are directly pathogenic. Therefore, they present a prognostically better group. In everyday practice, the clinical classification into hypokinetic (Parkinsonism, stiff-person syndrome, progressive encephalomyelitis with rigidity and myoclonus), and hyperkinetic (tremor, myoclonus, dystonia, chorea, tics, stereotypies and sleep-related movement disorders) movement disorders is more applicable. For the diagnosis, the confirmation of typical antibodies in the serum and/or cerebrospinal fluid is essential, other paraclinical findings are nonspecific. Many autoimmune movement disorders are part of a paraneoplastic syndrome, which is why we have to actively look for an accompanying neoplasm. The treatment is based on immunotherapy, which may promote improvement of symptoms or even full recoveryAvtoimunske motnje gibanja predstavljajo redko skupino bolezni, ki nastane zaradi pretiranega imunskega odziva proti nevronalnim antigenom. Patofiziološko jih razdelimo na motnje gibanja, povezane s protitelesi proti znotrajceličnim antigenom, ki pogosteje potekajo paraneoplastično in slabše odgovorijo na imunoterapijo, in motnje gibanja, povezane s protitelesi proti membranskim antigenom, ki so neposredno patogena, zato predstavljajo prognostično ugodnejšo skupino. V vsakodnevni praksi je uporabnejša klinična razdelitev na hipokinetične (parkinsonizem, sindrom otrdelosti, progresivni encefalomielitis z rigidnostjo in mioklonusom ) in hiperkinetične (tremor, mioklonus, distonija, horea, tiki, stereotipije in motnje gibanja, povezane s spanjem) motnje gibanja. Za diagnozo je ključna potrditev značilnih protiteles v serumu in/ali likvorju, preostale preiskave so nespecifične. Velik del avtoimunskih motenj gibanja je del paraneoplastičnega sindroma, zato je treba aktivno iskati spremljajoči tumor. Temelj zdravljenja predstavlja imunoterapija, s katero lahko dosežemo izboljšanje simptomov in celo popolno okrevanjeTEXTznanstveno časopisjejournalsSlovenian National E-content AggregatorNational and University Library of SloveniaDruštvo Medicinski razgledi