MRI findings in glutamic acid decarboxylase associated autoimmune epilepsy

Purpose Glutamic acid decarboxylase (GAD65) has been implicated in a number of autoimmune-associated neurologic syndromes, including autoimmune epilepsy. This study categorizes the spectrum of MRI findings in patients with a clinical diagnosis of autoimmune epilepsy and elevated serum GAD65 autoanti...

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Bibliographic Details
Published in:Neuroradiology 2018-03, Vol.60 (3), p.239-245
Main Authors: Fredriksen, Jason R., Carr, Carrie M., Koeller, Kelly K., Verdoorn, Jared T., Gadoth, Avi, Pittock, Sean J., Kotsenas, Amy L.
Format: Article
Language:English
Subjects:
Abnormalities
Antibodies
Atrophy
Autoantibodies
Autoimmunity
Brain
Cerebellum
Convulsions & seizures
Cortex
Diagnosis
Diagnostic Neuroradiology
Electronic medical records
Epilepsy
Glutamate decarboxylase
Glutamic acid
Hippocampus
Identification methods
Imaging
Magnetic resonance imaging
Medical electronics
Medicine
Medicine & Public Health
Meninges
Neuroimaging
Neurology
Neuroradiology
Neurosciences
Neurosurgery
Patients
Radiology
Sclerosis
Seizures
Temporal lobe
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Summary:Purpose Glutamic acid decarboxylase (GAD65) has been implicated in a number of autoimmune-associated neurologic syndromes, including autoimmune epilepsy. This study categorizes the spectrum of MRI findings in patients with a clinical diagnosis of autoimmune epilepsy and elevated serum GAD65 autoantibodies. Methods An institutional database search identified patients with elevated serum GAD65 antibodies and a clinical diagnosis of autoimmune epilepsy who had undergone brain MRI. Imaging studies were reviewed by three board-certified neuroradiologists and one neuroradiology fellow. Studies were evaluated for cortical/subcortical and hippocampal signal abnormality, cerebellar and cerebral volume loss, mesial temporal sclerosis, and parenchymal/leptomeningeal enhancement. The electronic medical record was reviewed for relevant clinical information and laboratory markers. Results A study cohort of 19 patients was identified. The majority of patients were female (84%), with a mean age of onset of 27 years. Serum GAD65 titers ranged from 33 to 4415 nmol/L (normal
ISSN:0028-3940
1432-1920
DOI:10.1007/s00234-018-1976-6