Anti-GAD antibodies and periodic alternating nystagmus.
نویسندگان
چکیده
BACKGROUND Autoantibodies directed against glutamic acid decarboxylase (GAD-Ab) have recently been described in a few patients with progressive cerebellar ataxia, suggesting an autoimmune physiopathologic mechanism. OBJECTIVE To determine the exact role of GAD-Ab and gamma-aminobutyric acid (GABA)-ergic neurotransmission in the pathogenesis of cerebellar ataxia. DESIGN Case report. SETTING University neurological hospital. PATIENT We report the case of a patient with subacute cerebellar ataxia associated with GAD-Ab showing periodic alternating nystagmus (PAN). INTERVENTION Baclofen, a GABAergic medication, was given to the patient. MAIN OUTCOME MEASURES Eye movement recording of spontaneous nystagmus and postrotatory vestibular responses. RESULTS Baclofen was effective in suppressing PAN and improving postrotatory vestibular responses but not for improving cerebellar ataxia. CONCLUSION The presence of PAN and the response to baclofen provide a unique opportunity to suggest a direct role of GAD-Ab in cerebellar dysfunction in this patient.
منابع مشابه
Potential role of anti-GAD antibodies in abnormal eye movements.
Glutamic acid decarboxylase (GAD) catalyzes the conversion of glutamic acid to gamma-aminobutyric acid (GABA). Autoantibodies directed against GAD (antiGAD-Ab) have been described in patients with insulin-dependent diabetes mellitus, stiff-man syndrome, and in a few patients with progressive cerebellar ataxia. The presence of these autoantibodies suggests an autoimmune pathophysiological mechan...
متن کاملP102: The Association of the Anti-GAD Antibodies to the Neurological Conditions
Glutamic acid decarboxylase (GAD) is an enzyme which converts the glutamic acid to the neurotransmitter gamma-amino butyric acid (GABA). GABA is an inhibitory neurotransmitter that inhibits or weakens the neuronal stimulations. Presynaptic GABAergic neurons in the central neurons system (CNS) and the cells in the islets of Langerhans in the pancreas generate GAD. There are two isoforms of GAD n...
متن کاملEpilepsy and cerebellar ataxia associated with anti-glutamic acid decarboxylase antibodies.
Anti-glutamic acid decarboxylase (GAD) antibodies are described in stiff-person syndrome and also in other neurological syndromes, including cerebellar ataxia and epilepsy. This paper reports the case of a patient who had chronic focal epilepsy, upbeat nystagmus and cerebellar ataxia, associated with a polyautoimmune response including anti-GAD antibodies. Both gait and nystagmus improved marke...
متن کاملPositional periodic alternating vertical nystagmus with PCA-Tr antibodies in Hodgkin lymphoma.
متن کامل
Acquired Periodic Alternating Nystagmus
대한신경과학회지 22권 5호 548 Periodic alternating nystagmus (PAN) is a rare type of spontaneous horizontal nystagmus, characterized by periodical reverse of direction with a transition period in between. PAN can occur in both congenital and acquired forms. We report a patient with acquired PAN associated with meningoencephalitis. To our knowledge, only a case of congenital PAN has been previously report...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
- Archives of neurology
دوره 62 8 شماره
صفحات -
تاریخ انتشار 2005