Jaafar Fatima, Haddad Laith, Koleilat Nadia, Sharara-Chami Rana, Shbarou Rolla
Division of Child Neurology, Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Division of Pediatric Critical Care, Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Epilepsy Behav Rep. 2020 Oct 17;14:100396. doi: 10.1016/j.ebr.2020.100396. eCollection 2020.
Antibodies against glutamic acid decarboxylase are reported in association with a number of neurological conditions including limbic encephalitis. We report a case of anti-GAD-antibody associated encephalitis presenting with super-refractory status epilepticus. We describe the clinical course, management, and the outcome. In addition, we review the presentation and outcomes of reported cases of anti-GAD encephalitis. Similar to the reported cases of anti-GAD encephalitis, our case was refractory to treatment with conventional antiseizure medication. Treatment with intravenous immune globulin (IVIG), high dose corticosteroids, and plasmapheresis had partial response, but escalation of treatment to the use of tocilizumab was associated with significant clinical improvement.
据报道，抗谷氨酸脱羧酶抗体与包括边缘性脑炎在内的多种神经系统疾病有关。我们报告一例抗GAD抗体相关脑炎患者，该患者表现为超难治性癫痫持续状态。我们描述了其临床病程、治疗及预后。此外，我们回顾了已报道的抗GAD脑炎病例的临床表现及预后。与已报道的抗GAD脑炎病例相似，我们的病例对传统抗癫痫药物治疗无效。静脉注射免疫球蛋白（IVIG）、高剂量皮质类固醇和血浆置换治疗有部分反应，但将治疗升级至使用托珠单抗后临床有显著改善。
