Epilepsy and cerebellar ataxia associated with anti-glutamic acid decarboxylase antibodies.
Anti-glutamic acid decarboxylase (GAD) antibodies are described in stiff-person syndrome and also in other neurological syndromes, including cerebellar ataxia and epilepsy. This paper reports the case of a patient who had chronic focal epilepsy, upbeat nystagmus and cerebellar ataxia, associated with a polyautoimmune response including anti-GAD antibodies. Both gait and nystagmus improved markedly after immunosuppressive treatment with corticosteroids and azathioprine. After the introduction of benzodiazepines, previously refractory seizures were completely controlled. Anti-GAD antibodies should be actively sought out in pharmacoresistant epilepsy, particularly if other neurological abnormalities are present. Combined treatment with immunosuppressants and gammahydroxybutyric acidergic agents may be highly effective.
Vulliemoz
S
S
Department of Neurology, University Hospital of Geneva, Geneva, Switzerland.
Vanini
G
G
Truffert
A
A
Chizzolini
C
C
Seeck
M
M
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D001323:Autoantibodies; D001379:Azathioprine / Q000627:therapeutic use; D002524:Cerebellar Ataxia / Q000188:drug therapy / Q000276:immunology*; D004827:Epilepsy / Q000188:drug therapy / Q000276:immunology*; D005968:Glutamate Decarboxylase / Q000276:immunology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009759:Nystagmus, Pathologic; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D001323:Autoantibodies; D007166:Immunosuppressive Agents; D005968:Glutamate Decarboxylase; D001379:Azathioprine