Anti-glutamic acid decarboxylase antibodies-associated cerebellar ataxia: A treatable ataxia
| Title: | Anti-glutamic acid decarboxylase antibodies-associated cerebellar ataxia: A treatable ataxia |
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| Authors: | Rohan Mahale, Sandeep M, Anita Mahadevan, Nitish Kamble, Vikram Holla, Ravindranadh Mundlamuri, Seena Vengalil, Netravathi M, Atchayaram Nalini, Pramod Kumar Pal, Ravi Yadav |
| Source: | Annals of Movement Disorders, Vol 7, Iss 1, Pp 13-18 (2024) |
| Publisher Information: | Wolters Kluwer Medknow Publications, 2024. |
| Publication Year: | 2024 |
| Collection: | LCC:Neurology. Diseases of the nervous system |
| Subject Terms: | anti-gad65 antibodies, cerebellar ataxia, glutamic acid decarboxylase, neoplasm, Neurology. Diseases of the nervous system, RC346-429 |
| More Details: | BACKGROUND: Anti-glutamate decarboxylase 65 antibody-associated cerebellar ataxia (anti-GAD65Ab-associated CA) is the most widely studied immune-mediated CA. There are few case series evaluating the clinical, radiological, treatment profile, and outcome of anti-GAD65Ab-associated CA. OBJECTIVE: To study the clinical, radiological profile, associated neoplasm, treatment outcome, and prognosis in patients diagnosed with anti-GAD65Ab-associated CA. METHODS: A retrospective descriptive analysis of a cohort of patients diagnosed with anti-GAD65Abassociated CA was performed and analyzed. RESULTS: Thirteen patients were selected for the analysis with female predominance (70%). The mean age at presentation was 47.5 } 11.1 years (range, 29–65 years), and the median duration of the symptoms was 4 months. All 13 patients (100%) had gait ataxia. Ten patients had limb ataxia along with gait ataxia (75%). Seven patients had cerebellar dysarthria (54%). Four patients (31%) had gazeevoked jerky nystagmus. Five patients (39%) were diagnosed with type 2 diabetes mellitus, and one patient had hypothyroidism in addition to type 2 diabetes mellitus. Brain magnetic resonance imaging was normal in seven (54%) patients, and pure cerebellar atrophy was observed in six patients. One patient was detected with a colon neoplasm. All 13 patients received intravenous methylprednisolone, followed by oral steroids over 3 months. Six patients (50%) received plasma exchange along with intravenous methylprednisolone. Favorable outcomes (modified Rankin scale score 2) were observed in five patients and poor outcomes in two; six patients were lost to follow-up after the first admission. CONCLUSION: Anti-GAD65Ab-associated CA presents as subacute to chronic progressive CA with a favorable outcome with immunotherapy. Anti-GAD antibodies should be assessed in serum or cerebrospinal fluid in patients presenting subacute to chronic sporadic CA. The occurrence of a systemic neoplasm is rare in anti-GAD65Ab-associated CA. |
| Document Type: | article |
| File Description: | electronic resource |
| Language: | English |
| ISSN: | 2590-3446 2590-3454 |
| Relation: | https://journals.lww.com/aomd/fulltext/2024/07010/anti_glutamic_acid_decarboxylase.3.aspx; https://doaj.org/toc/2590-3446; https://doaj.org/toc/2590-3454 |
| DOI: | 10.4103/aomd.aomd_23_23 |
| Access URL: | https://doaj.org/article/cf577d1688fc4560b2a7014730b47305 |
| Accession Number: | edsdoj.f577d1688fc4560b2a7014730b47305 |
| Database: | Directory of Open Access Journals |
| ISSN: | 25903446 25903454 |
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| DOI: | 10.4103/aomd.aomd_23_23 |
| Published in: | Annals of Movement Disorders |
| Language: | English |