الفهرس 
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Abstract
In recent years, the functional disturbances of the immune system, both humoral and cell-mediated immunity, have been detected more often among persons with epilepsy than in general population. Immune mechanisms have been implicated in the pathogenesis of epilepsy. An increased prevalence of autoantibodies, as well as changes in serum immunoglobulin concentrations, has been reported in patients with epilepsy.
The aim of this study was to clarify the seizure immunity interrelation by assessing serum Anti-ganglioside antibodies in pediatric patients with idiopathic intractable epilepsy and to correlate their serum levels with disease severity, disease duration and duration of AEDs .
The study was conducted on 20 children diagnosed as intractable idiopathic epilepsy. They were 9 males, and 11 females with mean age of 10.154.056 yrs attending the specialized neurology clinic, paediatric hospital, Ain Shams University. Four children suffered localization related epilepsy and 16 children with generalized epilepsy syndromes. Twenty apparently healthy age and sex matched children were enrolled as controls.
The main finding of our study was that serum level of both IgM and IgG anti-GM1 autoantibodies were statistically higher
Summary and Conclusion
in patients with idiopathic intractable epilepsy compared to controls.
There was no statistically significant difference between male and female patients as regards level of IgM autoantibodies, nor level of IgG autoantibodies. Also, there was no statistically significant difference between patients with positive consanguinity and those with negative consanguinity as regards level of IgM autoantibodies , nor level of IgG autoantibodies.
There was no statistically significant difference between patients with focal seizures and those with generalized seizures as regards level of IgM autoantibodies, nor level of IgG autoantibodies.
There was a highly significant statistically increase in serum level of IgM autoantibodies in patients with abnormal EEG when compared to patients with normal EEG . Yet, there was no statistically significant difference between patients with normal EEG recording and those with abnormal EEG recording as regards level of IgG autoantibodies.
Although there were no significant correlation between anti-GM1 IgG and IgM and duration of illness nor duration of treatment yet there were a significant correlation between level of IgG and IgM anti-ganglioside autoantibodies and seizure frequency, and IgG with the Chalfont severity scale.
Summary and Conclusion
IgM anti-GM1 was 100% sensitive 95% specific as a diagnostic marker in patients with idiopathic intractable epilepsy with cut off value 750 BTU. Also, IgG anti-GM1 was 95% sensitive 100% specific as a diagnostic marker in patients with idiopathic intractable epilepsy with cut off value 750 BTU.
from the results of the present study we could conclude that:
1- Anti-ganglioside autoantibodies increased in patients
with idiopathic intractable epilepsy, and their level were
positively correlated to the frequency and severity of
epileptic seizures.
2- These associations may suggest an immunomodulatory
role of seizures in inducing anti-ganglioside autoantibody
formation.
3- Anti-ganglioside autoantibodies can be used as indicator
for intractability in epileptic patients.