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Table 1 Clinical characteristics of six GAD65 positive-AE patients from our center

From: Intravenous methylprednisolone or immunoglobulin for anti-glutamic acid decarboxylase 65 antibody autoimmune encephalitis: which is better?

 Patient 1Patient 2Patient 3Patient 4Patient 5Patient 6
Past historyUnremarkableExcision of epileptogenic focus in 2015UnremarkableUnremarkableExcision of thymoma in 2013L Thyroidectomy
Family historyUnremarkableHyperthyroidism of his motherUnremarkableUnremarkableUnremarkableUnremarkable
Symptom onset2018/082000/?2016/062000/?2009/?2014/?
Initial symptomsSeizureSeizureSeizureSeizureSeizureSeizure
AEDsLEV, 1000 mg/dayLEV, 1000 mg/day; CBZ, 600 mg/day; CZP, 1 mg/dayCBZ, 500 mg/dayCZP, 4 mg/q8h; CBZ, 400 mg/qdOXC, 300 mg/q12h; LEV, 250 mg/q12hLEV, 625 mg/q12h; discontinuation by herself later
Seizure Frequency at the time of ImmunotherapyCPS, 2–3/day; sGTCS, 1–2/monthsGTCS, zero; CPS, 1/daySPS, 2–6/weekCPS, 2–4/week; sGTCS, 1–2/monthCPS, 1–2/day; sGTCS, 1–2/yearCPS, 2–13/day
MRI lesionsR MTL, Amy, HippAtrophy of L MTL, Hipp and B cerebellumB FLB MTLB HippL Hipp and Amy
18F-FDG-PET/CTHypometabolism of R TLNAHypometabolism of R Tha, L Hipp and TLHypometabolism of L TLHypometabolism of L TLHypometabolism of L TL
OthersThymus residueNoThymus residueNoThymomaNo
ComorbiditiesNoHyperthyroidism, LADANoNoMG; hyperthyroidismNo
Serum examination showing positive AbsNoANA, anti-mitochondrial M2 subtype abs, anti-Ro-52 abs, TPA, TGA, anti-cardiolipin absTPA, TGANoTPANo
Anti-GAD65 Abs, serum1:10 positive1:100 positiveNA, positive1:320 positive1:100 positive1:100 positive
Anti-GAD65 Abs, CSF1:100 positive1:100 positiveNA, positive1:320 positive1:320 positive1:100 positive
ImmunotherapyIVMP and prednisone tapered; IVIGIVIG twice, and MFIVIG and prednisone taperedIVMP and IVIG, medrol taperedIVMP and IVIG, prednisone taperedIVMP and IVIG, prednisone tapered
Outcome (2019.07)CPS, 2–3/monthCPS, 3–4/monthNAno more seizures; SPS* improvedno more CPS and sGTCSCPS, 1–2/day
  1. GAD65 glutamic acid decarboxylase 65, AE autoimmune encephalitis, F female, M male, SPS simple partial seizures, CPS complex partial seizures, sGTCS secondary generalized tonic–clonic seizures, MoCA montreal cognitive assessment, CI cognitive impairment, SPS* stiff person syndrome, CA cerebellar ataxia, NBC neurobehavioral changes, AEDs antiepileptic drugs, LEV levetiracetam, CBZ carbamazepine, CZP clonazepam, OXC oxcarbazepine, MRI magnetic resonance imaging, L left, R right, B bilateral, (M)TL (medial) temporal lobe, Amy amygdala, Hipp hippocampus, FL frontal lobe, 18F-FDG-PET/CT 18-fluoro-deoxyglucose-positron emission tomography/computed tomography, Tha thalamus, LADA late-onset type one diabetic, MG myasthenia gravis, abs antibodies, ANA antinuclear antibodies, TPA thyroid peroxidase antibody, TGA thyroglobulin antibody, CSF cerebrospinal fluid, IVMP intravenous methylprednisolone, IVIG intravenous immunoglobulin, MF mycophenolate mofetil, NA not available