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Management of autoimmune temporal lobe epilepsy with GAD65 antibody: four case reports.
Janszky, József; Bóné, Beáta; Karádi, Kázmér; Barsi, Péter; Juhos, Vera; Berta, Anikó; Gyimesi, Csilla; Tényi, Dalma; Horváth, Réka.
Afiliación
  • Janszky J; Department of Neurology, Medical School University of Pecs, Pécs, Hungary.
  • Bóné B; MTA-PTE Clinic, Neuroscience MR Research Group, Pécs, Hungary.
  • Karádi K; Department of Neurology, Medical School University of Pecs, Pécs, Hungary.
  • Barsi P; Department of Behavioural Sciences, Medical School, University of Pecs, Pécs, Hungary.
  • Juhos V; Medical Imaging Centre, Faculty of Medicine, Semmelweis University, Budapest, Korányi, Hungary.
  • Berta A; Epihope KKFT, Budapest, Hungary.
  • Gyimesi C; Department of Languages for Biomedical Purposes and Communication, Medical School, Pécs, Hungary.
  • Tényi D; Department of Neurology, Medical School University of Pecs, Pécs, Hungary.
  • Horváth R; Department of Neurology, Medical School University of Pecs, Pécs, Hungary.
Neurol Neurochir Pol ; 58(4): 453-458, 2024.
Article en En | MEDLINE | ID: mdl-39093166
ABSTRACT
AIM OF STUDY Glutamate decarboxylase (GAD) enzyme can be a target intracellular antigen in autoimmune focal epilepsy. GAD65 antibody is in found patients diagnosed with drug-refractory temporal lobe epilepsy (TLE). We explore the clinical features of the disease and therapeutic options. MATERIAL AND

METHODS:

We present the cases of four TLE patients, two of them with type 1 diabetes. All of them were drug-resistant and therefore underwent presurgical evaluation, which revealed GAD65 antibody positivity. We discuss the four GAD65 antibody positive temporal lobe epilepsy patients' electroclinical data, the treatments, and their effectiveness.

RESULTS:

One of them became seizure-free after right anterior temporal lobe resection, two of them did not show significant improvement with immunmodulatory agents, and the fourth patient with the shortest duration of disease had significant improvement in seizure status and normalisation of cognitive status with IVIg therapy. CONCLUSIONS AND CLINICAL IMPLICATIONS Our cases show that the earlier a GAD65 antibody is detected, the greater the chance of achieving seizure freedom or improvements in both seizure and cognitive status with immunomodulatory agents. However, in some cases, surgery may also bring seizure freedom, but with a risk of cognitive deterioration.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Autoanticuerpos / Epilepsia del Lóbulo Temporal / Glutamato Descarboxilasa Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Neurol Neurochir Pol Año: 2024 Tipo del documento: Article País de afiliación: Hungria Pais de publicación: Polonia
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Autoanticuerpos / Epilepsia del Lóbulo Temporal / Glutamato Descarboxilasa Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Neurol Neurochir Pol Año: 2024 Tipo del documento: Article País de afiliación: Hungria Pais de publicación: Polonia