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Epilepsy and cerebellar ataxia associated with anti-glutamic acid decarboxylase antibodies

¹ Department of Neurology, University Hospital of Geneva, Geneva, Switzerland
² Immunology and Allergy, Department of Internal Medicine, University Hospital of Geneva

Correspondence to:
Correspondence to:
M Seeck
Department of Neurology, University Hospital of Geneva, Micheli-du-Crest 24, 1211 Geneva 14, Switzerland; margitta.seeck{at}hcuge.ch

ABSTRACT
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 hydroxybutyric acidergic agents may be highly effective.

Abbreviations: CAPA, cerebellar ataxia with polyendocrine autoimmunity; GABA, hydroxybutyric acid; GAD, glutamic acid decarboxylase; GAD-Ab, autoantibodies against GAD; IDDM, insulin-dependent diabetes mellitus; MRI, magnetic resonance imaging; PET, positron emission tomography; SPS, stiff-person syndrome

This article has been cited by other articles:

				A. Saiz, Y. Blanco, L. Sabater, F. Gonzalez, L. Bataller, R. Casamitjana, L. Ramio-Torrenta, and F. Graus Spectrum of neurological syndromes associated with glutamic acid decarboxylase antibodies: diagnostic clues for this association Brain, August 7, 2008; (2008) awn183v1. [Abstract] [Full Text] [PDF]

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