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

J Neurol Neurosurg Psychiatry. 2007 Feb;78(2):187-9. doi: 10.1136/jnnp.2006.089268.

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 gammahydroxybutyric acidergic agents may be highly effective.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Autoantibodies*
  • Azathioprine / therapeutic use
  • Cerebellar Ataxia / drug therapy
  • Cerebellar Ataxia / immunology*
  • Epilepsy / drug therapy
  • Epilepsy / immunology*
  • Glutamate Decarboxylase / immunology*
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Male
  • Middle Aged
  • Nystagmus, Pathologic
  • Treatment Outcome

Substances

  • Adrenal Cortex Hormones
  • Autoantibodies
  • Immunosuppressive Agents
  • Glutamate Decarboxylase
  • Azathioprine