D'Souza Caitlin E, Feyissa Anteneh M
Department of Neurology, Mayo Clinic, Jacksonville, FL, USA.
Epileptic Disord. 2018 Jun 1;20(3):204-208. doi: 10.1684/epd.2018.0971.
Antibodies against the 65-kDa isoform of the intracellular enzyme, glutamate decarboxylase (GAD65), have been found in patients with limbic encephalitis and drug-resistant autoimmune epilepsy. We report a 22-year-old female who presented with new-onset seizures and neuropsychiatric symptoms. Video-EEG captured unique, independent bitemporal-onset focal seizures with impaired awareness and ictal asystole. An autoimmune epilepsy panel revealed elevated GAD65 antibodies in the serum (225 nmol/l) and CSF (2.78 nmol/l), while [F]-fluoro-deoxy-glucose positron emission tomography showed bitemporal hypometabolism (left > right). The patient was diagnosed with GAD65 antibody-associated autoimmune epilepsy. Our observation adds to the spectrum of neurocardiac syndromes associated with autoimmune epilepsy.
在边缘性脑炎和耐药性自身免疫性癫痫患者中发现了针对细胞内酶谷氨酸脱羧酶65 kDa亚型（GAD65）的抗体。我们报告了一名22岁女性，她出现了新发癫痫和神经精神症状。视频脑电图记录到独特的、独立的双侧颞叶起始局灶性癫痫发作，伴有意识障碍和发作期心脏停搏。自身免疫性癫痫检测显示血清（225 nmol/l）和脑脊液（2.78 nmol/l）中GAD65抗体升高，而[F] - 氟脱氧葡萄糖正电子发射断层扫描显示双侧颞叶代谢减低（左侧>右侧）。该患者被诊断为GAD65抗体相关的自身免疫性癫痫。我们的观察结果扩展了与自身免疫性癫痫相关的神经心脏综合征的范围。
