期刊
JOURNAL OF CHILD NEUROLOGY
卷 27, 期 11, 页码 1470-1481出版社
SAGE PUBLICATIONS INC
DOI: 10.1177/0883073812451327
关键词
autoantibody; sydenham chorea; dystonia-parkinsonism; tics; dopamine; basal ganglia; poststreptococcal
资金
- National Health and Medical Research Council
- University of Sydney
- Multiple Sclerosis Research Australia
- Tourette Syndrome Association
- Petre Foundation
- Star Scientific Foundation
The basal ganglia are deep nuclei in the brain that include the caudate, putamen, globus pallidus, and substantia nigra. Pathological processes involving the basal ganglia often result in disorders of movement and behavior. A number of different autoimmune disorders predominantly involve the basal ganglia and can result in movement and psychiatric disorders. The classic basal ganglia autoimmune disorder is Sydenham chorea, a poststreptococcal neuropsychiatric disorder. Resurgence in the interest in Sydenham chorea is the result of the descriptions of other poststreptococcal neuropsychiatric disorders including tics and obsessive-compulsive disorder, broadly termed pediatric autoimmune neuropsychiatric disorders associated with streptococcal infection. Encephalitic processes affecting the basal ganglia are also described including the syndromes basal ganglia encephalitis, encephalitis lethargica, and bilateral striatal necrosis. Last, systemic autoimmune disorders such as systemic lupus erythematosus and antiphospholipid syndrome can result in chorea or parkinsonism. Using paradigms learned from other autoantibody associated disorders, the authors discuss the autoantibody hypothesis and the role of systemic inflammation in autoimmune basal ganglia disorders. Identification of these entities is important as the clinician has an increasing therapeutic repertoire to modulate or suppress the aberrant immune system.
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