Longitudinal EEG Characteristics of Anti-GAD65 Antibody Related Autoimmune Epilepsy.

Tian Wang, Cameron Mohammadi, Robert K Shin, Tricia Y Ting
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Abstract

There is limited evidence on the management of patients with glutamic acid decarboxylase (GAD) antibody associated autoimmune epilepsy, or GAD positive (GAD+) epilepsy. We describe six GAD + epilepsy patients presenting with seizure and refractory status epilepticus with special emphasis on the longitudinal electrographic changes in relationship to immunologic and anti-seizure medication therapies. All patients presented with new onset seizure with four patients having refractory status epilepticus. Serial prolonged continuous EEG changes before and after immunotherapy were collected which demonstrated electrographic seizures are often pharmacoresistent and immunotherapy can result in seizure cessation and improvement of interictal discharges prior to clinical improvement. Our findings suggested GAD + epilepsy was controlled more effectively with immunotherapy than ASMs and serial prolonged continuous EEG monitoring can serve as a biomarker for disease outcome.

抗gad65抗体相关自身免疫性癫痫的纵向脑电图特征
关于谷氨酸脱羧酶(GAD)抗体相关自身免疫性癫痫或GAD阳性(GAD+)癫痫患者的管理证据有限。我们描述了6例GAD +癫痫患者表现为癫痫发作和难治性癫痫持续状态,特别强调纵向电图变化与免疫和抗癫痫药物治疗的关系。所有患者均出现新发癫痫,其中4例患者有难治性癫痫持续状态。我们收集了免疫治疗前后连续延长的脑电图变化,表明癫痫发作通常是药物抵抗性的,免疫治疗可以在临床改善之前导致癫痫发作停止和间歇放电的改善。我们的研究结果表明,免疫治疗比asm更有效地控制GAD +癫痫,连续长时间连续脑电图监测可以作为疾病结局的生物标志物。
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