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BMJ Case Rep. 2009;2009. pii: bcr09.2008.0977. doi: 10.1136/bcr.09.2008.0977. Epub 2009 Feb 2.

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

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1
University Hospital, rue Micheli-du Crest 24, Geneva, 1211, Switzerland.

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 γhydroxybutyric acidergic agents may be highly effective.

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