Investigators at University of New South Wales, Sydney, Australia, and Boston Children's Hospital, Harvard Medical School, conducted a retrospective population-level study of the relationship between epilepsy and 12 common autoimmune diseases: type 1 diabetes mellitus, psoriasis, rheumatoid arthritis, Graves disease, Hashimoto thyroiditis, Crohn disease, ulcerative colitis, systemic lupus erythematosus, antiphospholipid syndrome, Sjogren syndrome, myasthenia gravis, and celiac disease. The risk of epilepsy was significantly heightened among patients with all autoimmune diseases (P< 0.001), and especially in children. Children with autoimmune diseases had a 5-fold increased risk of epilepsy. [1]

COMMENTARY. The authors theorize that the occurrence of epilepsy in patients with autoimmune disease (AD) might be attributable to the inflammatory component of AD [1]. Also, certain anticonvulsant drugs, such as valproate and carbamazepine, are anti-inflammatory, and some anti-inflammatory drugs have anticonvulsant properties [2].

Investigators at the Lurie Children's Hospital of Chicago have provided several reports of the role of brain inflammation in epileptogenesis. Cortical tissue collected from children with intractable epilepsy at time of surgery showed active neuroinflammation and marked cellular injury [3]. In a review of brain inflammation in the pathogenesis of epilepsy, common pediatric autoimmune diseases are implicated, and the effective use of anti-inflammatory treatments of intractable epilepsy, such as steroids, is documented [4].