Acute limbic encephalitis and glutamic acid decarboxylase antibodies: a reality?
Limbic encephalitis (LE) associated with glutamic acid decarboxylase antibodies (GAD-Ab) is rare. We describe a 30-year-old male with acute LE and GAD-Ab, with follow-up during 2 years of cognitive status including verbal episodic memory, number of seizures recorded by high-resolution video-EEG, brain MRI, 2-[18F]-fluoro-2-deoxyglucose PET and GAD-Ab titres. Treatment with corticosteroids, IV immunoglobulins, immunosuppressors and antiepileptic drugs resulted in improved memory status, disappearance of seizures and decreased GAD-Ab titres. Review of the other cases of literature and this case is in favour of the existence of autoimmune LE associated with GAD-Ab and supports the link between memory, temporal seizures and possibly GAD-Ab titres.
Services of Neuropsychology, Neurology and Epileptology, Department of Neurology, University Hospital of Strasbourg, Strasbourg, France. Frederic.Blanc@chru-Strasbourg.fr
F
F
Blanc
E
E
Ruppert
C
C
Kleitz
M P
MP
Valenti
B
B
Cretin
R L
RL
Humbel
J
J
Honnorat
I J
IJ
Namer
E
E
Hirsch
L
L
Manning
J
J
de Seze
D000208:Acute Disease; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001323:Autoantibodies / Q000032:analysis / Q000097:blood*; D015415:Biomarkers / Q000032:analysis / Q000097:blood; D004569:Electroencephalography; D004827:Epilepsy / Q000201:enzymology / Q000276:immunology / Q000503:physiopathology; D005968:Glutamate Decarboxylase / Q000276:immunology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D020363:Limbic Encephalitis / Q000201:enzymology* / Q000276:immunology* / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008569:Memory Disorders / Q000201:enzymology / Q000276:immunology / Q000503:physiopathology; D009483:Neuropsychological Tests; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D005680:gamma-Aminobutyric Acid / Q000096:biosynthesis
D000893:Anti-Inflammatory Agents; D001323:Autoantibodies; D015415:Biomarkers; D007166:Immunosuppressive Agents; D005680:gamma-Aminobutyric Acid; D005968:Glutamate Decarboxylase; C401141:glutamate decarboxylase 2