GAD65 Antibody-Associated Epilepsy
Abstract
:1. Introduction
2. Case Report
3. Review of Literature and Discussion
3.1. Etiology and Pathogenesis
3.2. Clinical Presentation, Workup, and Diagnosis
3.3. Treatment
3.4. Autoimmune-Associated Epilepsy (GAD65)
4. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Acute Symptomatic Seizures Secondary to Autoimmune Encephalitis | Autoimmune-Associated Epilepsy | |
---|---|---|
Antibodies involved | Antibodies against neuronal surface antigens (e.g., NMDAR, LGI1, GABABR, GABAAR). | Antibodies against intracellular antigens (anti-GAD and onconeural antibodies). |
Pathogenesis | Antibodies often target synaptic proteins that lead to the downregulation of receptors, which alters synaptic transmission. | Cellular immunity (T-cell-mediated brain inflammation) is the main factor leading to pathological changes. Ongoing immune response, structural damage to the brain parenchyma, or combination of both. Recurrent seizures 12 or 24 months after the acute phase of autoimmune encephalitis. Rasmussen’s encephalitis. |
Clinical presentation | Very variable and includes combinations of seizures, prominent psychiatric manifestations, sleep and movement disorders, memory impairment, and autonomic instability. MRI is often abnormal. | There are no other neurological signs and drug-resistant epilepsy is most frequently the only clinical feature. MRI is usually unremarkable. |
Treatment | Usually, there is a good response to immunotherapy, which is the mainstay of treatment. Antiseizure medications. | Poor response to immunotherapy and resistance to antiseizure medications. Epilepsy surgery is rarely effective. |
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Valinčiūtė, J.; Jucevičiūtė, N.; Balnytė, R.; Jurkevičienė, G.; Gelžinienė, G. GAD65 Antibody-Associated Epilepsy. Medicina 2023, 59, 1135. https://doi.org/10.3390/medicina59061135
Valinčiūtė J, Jucevičiūtė N, Balnytė R, Jurkevičienė G, Gelžinienė G. GAD65 Antibody-Associated Epilepsy. Medicina. 2023; 59(6):1135. https://doi.org/10.3390/medicina59061135
Chicago/Turabian StyleValinčiūtė, Justina, Neringa Jucevičiūtė, Renata Balnytė, Giedrė Jurkevičienė, and Giedrė Gelžinienė. 2023. "GAD65 Antibody-Associated Epilepsy" Medicina 59, no. 6: 1135. https://doi.org/10.3390/medicina59061135