Immune-mediated epilepsy with GAD65 antibodies

Anti-GAD65 antibodies have been identified in both acute/subacute seizures (limbic encephalitis and extralimbic encephalitis) and chronic isolated epilepsy. The evidence of high serum titers and intrathecal synthesis play a fundamental role in diagnosis but poorly correlate with disease severity or response to therapies. It remains controversial whether anti-GAD65 Abs are the pathogenic entity or only serve as a surrogate marker for autoimmune disorders mediated by cytotoxic T cells. Unlike other immune-mediated epilepsy, although multiple combinations of therapeutics are used, the efficacy and prognosis of patients with GAD65-epilepsy patients are poor.
Source: Journal of Neuroimmunology - Category: Allergy & Immunology Authors: Tags: Review Article Source Type: research

Related Links:

ConclusionsIn appropriately selected patients, FDG-PET scans while in burst suppression may help dissect the underlying pathophysiologic cause of IIC findings observed on EEG and guide tailored therapy.
Source: Neurocritical Care - Category: Neurology Source Type: research
Authors: Endres D, Leypoldt F, Bechter K, Hasan A, Steiner J, Domschke K, Wandinger KP, Falkai P, Arolt V, Stich O, Rauer S, Prüss H, van Elst LT Abstract Primary schizophreniform psychoses are thought to be caused by complex gene-environment interactions. Secondary forms are based on a clearly identifiable organic cause, in terms of either an etiological or a relevant pathogenetic factor. The secondary or "symptomatic" forms of psychosis have reentered the focus stimulated by the discovery of autoantibody (Ab)-associated autoimmune encephalitides (AEs), such as anti-NMDA-R encephalitis, which can at...
Source: European Archives of Psychiatry and Clinical Neuroscience - Category: Psychiatry Tags: Eur Arch Psychiatry Clin Neurosci Source Type: research
AbstractPrimary schizophreniform psychoses are thought to be caused by complex gene –environment interactions. Secondary forms are based on a clearly identifiable organic cause, in terms of either an etiological or a relevant pathogenetic factor. The secondary or “symptomatic” forms of psychosis have reentered the focus stimulated by the discovery of autoantibody (Ab)-associa ted autoimmune encephalitides (AEs), such as anti-NMDA-R encephalitis, which can at least initially mimic variants of primary psychosis. These newly described secondary, immune-mediated schizophreniform psychoses typically present wi...
Source: European Archives of Psychiatry and Clinical Neuroscience - Category: Neuroscience Source Type: research
Conclusion Most patients with high anti-GAD65 concentrations (>10,000 IU/mL) showed some improvement after immunotherapy, unfortunately without complete recovery. Serum antibody concentrations' course might be useful to monitor response. In patients with low anti-GAD65 concentrations, especially in those without typical clinical phenotypes, diagnostic alternatives are more likely.
Source: Neurology Neuroimmunology and Neuroinflammation - Category: Neurology Authors: Tags: Autoimmune diseases, Gait disorders/ataxia, Stiff person syndrome Article Source Type: research
Conclusions: Thirty-two AE patients were recruited over 18 months. Twenty-one viral controls, 10 NI controls, and five other autoimmune neurological disease controls (AOND) were also included in the analysis. Our study found that conventional markers: presence of CSF monocytosis, oligoclonal bands, anti-neuronal immunofluorescence, and magnetic resonance imaging (MRI) changes could be suggestive of AE, but these investigations were neither sensitive nor specific. Promising novel makers of autoimmune encephalitis were the CSF cytokines IL-21 and IP10 which may provide better delineation between viral infections and autoimmu...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Rationale: Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is an autoimmune disease that is associated with cell-surface NMDAR-targeting autoantibodies. Typical anti-NMDAR encephalitis symptoms include psychosis, seizure and extrapyramidal side effects. However, early diagnosis of anti-NMDAR encephalitis remains challenging due to the complexity of the motor phenomenon. Patient concerns: Here, we report a new diagnosis of anti-NMDAR encephalitis in a young woman with a history of epilepsy. Diagnoses: Electroencephalography revealed a typical “extreme delta brush” pattern, which indicated an...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
ConclusionsMost patients have autoimmune or limbic encephalitis and corresponding abnormalities on neuroimaging. Other presentations include peripheral nerve hyperexcitability or Morvan syndromes, cerebellar syndromes, behavioral and cognitive changes, and more rarely movement disorders. The most commonly associated malignancy was thymoma and suggests a role for thymoma screening in CASPR2-related diseases.
Source: Journal of Neurology - Category: Neurology Source Type: research
CONCLUSIONS: Although autonomic nervous dysfunction occurred in our patient, her prognosis was good because she did not have respiratory or (and) circulatory failure. Exclusive diagnosis and early treatment are important in patients with anti-NMDAR encephalitis. Abdominal pain with positive HTT may be a manifestation of autonomic dysfunction in this disease. PMID: 31858566 [PubMed - in process]
Source: European Review for Medical and Pharmacological Sciences - Category: Drugs & Pharmacology Tags: Eur Rev Med Pharmacol Sci Source Type: research
Bilateral hippocampal lesions can be a feature in both infectious and autoimmune limbic encephalitis. Although rare, mumps meningoencephalitis should be considered in the differential diagnosis of bilateral hippocampal lesions, especially in the presence of symptoms suggestive of systemic and/or CNS infection.
Source: Neurology Clinical Practice - Category: Neurology Authors: Tags: MRI, Encephalitis, All Clinical Neurology, All Cerebrovascular disease/Stroke, EEG; see Epilepsy/Seizures Case Source Type: research
Autoimmune encephalitis should be considered when patients with posterior reversible encephalopathy syndrome show atypical clinical courses.
Source: Neurology Clinical Practice - Category: Neurology Authors: Tags: MRI, Autoimmune diseases, Encephalitis, All Clinical Neurology, All Epilepsy/Seizures Case Source Type: research
More News: Allergy & Immunology | Autoimmune Disease | Brain | Encephalitis | Epilepsy | Neurology