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Menon et al. Pediatric anti-GAD antibody mediated encephalitis

concomitant DM1 and other endocrine autoimmune 7. Takenoshita H, Shizuka-Ikeda M, Mitoma H, Song S, Harigaya Y, Igeta
disorders, longitudinal follow-up in our patients is likely Y, Yaguchi M, Ishida K, Shoji M, Tanaka M, Mizusawa H, Okamoto
to be provide more insight. The antibody titres were K. Presynapticinhibition of cerebellar GABAergic transmission by
not extremely elevated as in reference cases in Table 1, glutamatedecarboxylase autoantibodies in progressive cerebellar ataxia.
J Neurol Neurosurg Psychiatry 2001;70:386-9.
however, the possibility of an alternative diagnosis 8. Geis C, Weishaupt A, Hallermann S, Grünewald B, Wessig C, Wultsch
has been reliably excluded by investigations. Despite T, Reif A, Byts N, Beck M, Jablonka S, Boettger MK, Üçeyler N,
the inability to demonstrate intrethecal synthesis, the Fouquet W, Gerlach M, Meinck HM, Sirén AL, Sigrist SJ, Toyka
dramatic response to immunomodulation demonstrated KV, Heckmann M, Sommer C. Stiff person syndrome-associated
in both patients highlights the significance of evaluating autoantibodies to amphiphysin mediate reduced GABAergic inhibition.
for these antibodies in children with chronic refractory Brain 2010;133:3166-80.
partial epilepsy with epileptic encephalopathy of 9. Lancaster E, Lai M, Peng X, Hughes E, Constantinescu R, Raizer
J, Friedman D, Skeen MB, Grisold W, Kimura A, Ohta K, Iizuka T,
uncertain etiology and acute-subacute myoclonus- Guzman M, Graus F, Moss SJ, Balice-Gordon R, Dalmau J. Antibodies
ataxia syndromes. to the GABA(B) receptor in limbic encephalitis with seizures: case
series and characterisation of the antigen. Lancet Neurol 2010;9:67-76.
Financial support and sponsorship 10. Hutchinson M, Waters P, McHugh J, Gorman G, O’Riordan S, Connolly
Nil. S, Hager H, Yu P, Becker CM, Vincent A. Progressive encephalomyelitis,
rigidity, and myoclonus: a novel glycine receptor antibody. Neurology
2008;71:1291-92.
Conflicts of interest 11. Rosenfeld MR, Titulaer MJ, and Dalmau J. Paraneoplastic syndromes
There are no conflicts of interest. and autoimmune encephalitis: five new things. Neurol Clin Pract
2012;2:215-23.
Patient consent 12. Liimatainen S, Peltola J, Hietaharju A, Sabater L, Lang B. Lack of
Obtained. antibodies to NMDAR or VGKC-complex in GAD and cardiolipin
antibody-positive refractory epilepsy. Epilepsy Res 2014;108:592-6.
Ethics approval 13. Ozkan M, Aksoy A, Çenesiz F, Atay NE, Yüksel D. The association of
Ethics approval was obtained from Institute Review anti-glutamic acid decarboxylase antibodies with different neurological
Board for case reports. findings in childhood. Epilepsy Behav 2012;25:464-7.
14. Player B, Harmelink M, Bordini B, Weisgerber M, Girolami M, Croix
M. Pediatric opsoclonus-myoclonus-ataxia syndrome associated
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224 Neuroimmunology and Neuroinflammation ¦ Volume 3 ¦ September 28, 2016