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Non-convulsive status epilepticus associated with glutamic acid decarboxylase antibody.

Research paper by Ugur U Cikrikçili, Canan C Ulusoy, Selin S Turan, Senay S Yildiz, Basar B Bilgiç, Hasmet H Hanagasi, Betül B Baykan, Erdem E Tüzün, Hakan H Gürvit

Indexed on: 04 Jul '13Published on: 04 Jul '13Published in: Clinical EEG and neuroscience



Abstract

Autoimmune encephalitis associated with glutamic acid decarboxylase antibodies (GAD-Ab) often presents with treatment-resistant partial seizures, as well as other central nervous system symptoms. In contrast to several other well-characterized autoantibodies, GAD-Ab has very rarely been associated with status epilepticus. We report a 63-year-old woman initially admitted with somnolence and psychiatric findings. The EEG findings, of generalized and rhythmical slow spike-wave activity over the posterior regions of both hemispheres, together with the clinical deterioration in responsiveness, led to the diagnosis of non-convulsive status epilepticus. Investigation of a broad panel of autoantibodies, revealed only increased serum GAD-Ab levels. Following methylprednisolone and intravenous immunoglobulin treatments, the patient's neurological symptoms improved, EEG findings disappeared and GAD-Ab levels significantly decreased. GAD-Ab should be added to the list of anti-neuronal antibodies associated with non-convulsive status epilepticus. Disappearance of clinical findings and seroreversion after immunotherapy suggest that GAD-Ab might be involved in seizure pathogenesis.