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Volume 09
Journal of Alzheimers Disease & Parkinsonism
ISSN: 2161-0460
Epilepsy 2019
Parkinsons Congress 2019
August 29-31, 2019
JOINT EVENT
conferenceseries
.com
August 29-31, 2019 Vienna, Austria
&
5
th
International Conference on
Epilepsy & Treatment
5
th
World Congress on
Parkinsons & Huntington Disease
Epilepsy spectrum associated to anti-glutamic acid decarboxylase antibody
Ines Bedoui
Military Hospital of Tunis, Tunisia
Introduction:
Anti-glutamic acid decarboxylase antibodies (GAD), initially described in type 1 diabetics, have
been recently identified in some patients with epilepsy. Glutamic acid decarboxylase (GAD) antibody-associated
encephalitis causes both acute seizures and chronic epilepsy with predominantly temporal lobe onset. The incidence
of GAD antibody related epilepsy could be much higher than commonly believed.
Objective:
The purpose of our work was to review the physiology, pathology, clinical presentation and management
of GAD associated epilepsy.
Results:
We included in our study 15 patients, 11 women and 4 men. The mean age of the beginning of the epilepsy
was 41, 3±6 years old. All of them had pharmaco-resistant epilepsy. Neuro-cognitive disorders were found in 13 cases
and movement disorders in 11 cases. A moderated lymphocytic pleocytosis was found in cerebro-spinal fluid (CSF)
examination in 10 patients. Anti GAD antibodies were positive in the blood in all patients, and in CSF in 8 cases.
Poorly responsive to antiepileptic drugs and moderately responsive to immune therapy with steroids, intravenous
immunoglobulin and plasma exchange are obtained in all patients.
Discussion and Conclusions:
Imaging and CSF evidence of inflammation along with typical clinical presentations,
such as adult onset temporal lobe epilepsy (TLE) with unexplained etiology, should prompt testing anti GAD
antibodies. Anti-GAD65 mediated epilepsy is often poorly responsive to antiepileptic drugs and only moderately
responsive to immune therapy with steroids, intravenous immunoglobulin, or plasma exchange. Long-term
treatment with more aggressive immunosuppressant such as rituximab and/or cyclophosphamide is often necessary
than current immunosuppressive approaches.
J Alzheimers Dis Parkinsonism 2019, Volume 09