Advertisement

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.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Multiple Sclerosis and Related Disorders
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Ariño H.
        • Höftberger R.
        • Gresa-Arribas N.
        • Martínez-Hernández E.
        • Armangue T.
        • Kruer M.C.
        • Arpa J.
        • Domingo J.
        • Rojc B.
        • Bataller L.
        • Saiz A.
        • Dalmau J.
        • Graus F.
        Paraneoplastic neurological syndromes and glutamic acid decarboxylase antibodies.
        JAMA Neurol. 2015; 72 (Aug): 874-881https://doi.org/10.1001/jamaneurol.2015.0749
        • Incecik F.
        • Herguner O.M.
        • Besen S.
        • Yılmaz M.
        Autoimmune encephalitis associated with glutamic acid decarboxylase antibodies: a case series.
        Acta Neurol. Belg. 2018; 118 (Sep): 411-414https://doi.org/10.1007/s13760-018-0880-5. Epub 2018 Jan 18
        • Lancaster E.
        The diagnosis and treatment of autoimmune encephalitis.
        J. Clin. Neurol. 2016; 12 (Jan): 1-13https://doi.org/10.3988/jcn.2016.12.1.1
        • O'Connor K.
        • Waters P.
        • Komorowski L.
        • Zekeridou A.
        • Guo C.Y.
        • Mgbachi V.C.
        • Probst C.
        • Mindorf S.
        • Teegen B.
        • Gelfand J.M.
        • Geschwind M.D.
        • Lennon V.
        • Pittock S.J.
        • McKeon A.
        GABAA receptor autoimmunity: a multicenter experience.
        Neurol. Neuroimmunol. Neuroinflamm. 2019; 6 (Apr 4May): e552https://doi.org/10.1212/NXI.0000000000000552. eCollection 2019
        • Pittock S.J.
        • Yoshikawa H.
        • Ahlskog J.E.
        • Tisch S.H.
        • Benarroch E.E.
        • Kryzer T.J.
        • Lennon V.A.
        Glutamic acid decarboxylase autoimmunity with brainstem, extrapyramidal, and spinal cord dysfunction.
        Mayo Clin. Proc. 2006; 81 (Sep): 1207-1214
        • Saiki S.
        • Ueno Y.
        • Moritani T.
        • Sato T.
        • Sekine T.
        • Kawajiri S.
        • Adachi S.
        • Yokoyama K.
        • Tomizawa Y.
        • Motoi Y.
        • Hattori N.
        Extensive hemispheric lesions with radiological evidence of blood-brain barrier integrity in a patient with neuromyelitis optica.
        J. Neurol. Sci. 2009; 284 (Sep 15 Epub 2009 Jun 3): 217-219https://doi.org/10.1016/j.jns.2009.05.022