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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 γhydroxybutyric acidergic agents may be highly effective.

  • CAPA, cerebellar ataxia with polyendocrine autoimmunity
  • GABA, γhydroxybutyric 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

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