Correspondence| Volume 44, 102331, September 2020

Large hemispheric lesions in autoimmune encephalitis associated with anti-GAD 65 antibodies

      There are several types of autoimmune encephalitis which share overlapping neuroimaging findings and clinical features, often identified and differentiated by the specific antibody type. Anti-glutamic acid decarboxylase (GAD) antibodies bind to GAD enzyme, and are essential in formation of γ-aminobutyric acid (GABA), the primary inhibitory neurotransmitter of the brain. Patients testing positive for this antibody present with many different clinical pictures including limbic encephalitis, epilepsy, cerebellar ataxia, and stiff-person syndrome, collectively known as “anti-GAD neurological syndromes”. We present a rare case of GAD-65 antibody associated encephalitis, with large hemispheric lesions on imaging.
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