Acute limbic encephalitis and glutamic acid decarboxylase antibodies: A reality?
Received 7 May 2009; received in revised form 1 September 2009; accepted 4 September 2009. published online 28 September 2009.
Abstract
Limbic encephalitis (LE) associated with glutamic acid decarboxylase antibodies (GAD-Ab) is rare. We describe a 30-year-old male with acute LE and GAD-Ab, with follow-up during 2years of cognitive status including verbal episodic memory, number of seizures recorded by high-resolution video-EEG, brain MRI, 2-[18F]-fluoro-2-deoxyglucose PET and GAD-Ab titres. Treatment with corticosteroids, IV immunoglobulins, immunosuppressors and antiepileptic drugs resulted in improved memory status, disappearance of seizures and decreased GAD-Ab titres. Review of the other cases of literature and this case is in favour of the existence of autoimmune LE associated with GAD-Ab and supports the link between memory, temporal seizures and possibly GAD-Ab titres.
aServices of Neuropsychology, Neurology and Epileptology, Department of Neurology, University Hospital of Strasbourg, Strasbourg, France
bLINC (Cognitive Neurosciences and Imagery Laboratory), UMR 7191, Strasbourg University and CNRS, Strasbourg, France
cCMRR from Alsace (Memory Resource and Research Centre), Department of Neurology, University Hospital of Strasbourg, Strasbourg, France
dLaboratory of Immuno-pathology, Esch-sur-Alzette, Luxembourg
eDepartment of Neurology, Neurological Hospital, Lyon, France
fService of Nuclear Medicine, University Hospital of Strasbourg, Strasbourg, France
Corresponding author. Service of Neuropsychology, Department of Neurology, University Hospital of Strasbourg, 1, place de l'Hôpital. 67091, Strasbourg, France. Tel.: +33 388116892; fax: +33 388116343.
ABSTRACT