Transient Neurological Symptoms Preceding Cerebellar Ataxia with Glutamic Acid Decarboxylase Antibodies
| Autor: | Nicole Fabien, Hugo Chaumont, Véronique Rogemond, Anne-Laurie Pinto, Bastien Joubert, Jérôme Honnorat, Alberto Vogrig, Géraldine Picard, David Goncalves, Sergio Muñiz-Castrillo |
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| Rok vydání: | 2020 |
| Předmět: |
Gait Ataxia
medicine.medical_specialty Ataxia Cerebellar Ataxia genetic structures Stiff-Person Syndrome Nystagmus Gastroenterology 050105 experimental psychology Autoantibodies Cerebellar ataxia Diplopia Glutamic acid decarboxylase Vertigo 03 medical and health sciences 0302 clinical medicine Dysmetria Internal medicine medicine Humans 0501 psychology and cognitive sciences Aged Retrospective Studies Paroxysmal vertigo biology Glutamate Decarboxylase business.industry 05 social sciences biology.organism_classification medicine.disease Neurology Neurology (clinical) medicine.symptom business 030217 neurology & neurosurgery |
| Zdroj: | The Cerebellum. 19:715-721 |
| ISSN: | 1473-4230 1473-4222 |
| DOI: | 10.1007/s12311-020-01159-x |
| Popis: | A prompt diagnosis and treatment of patients with autoimmune cerebellar ataxia (CA) with antibodies against glutamic acid decarboxylase (GAD-Abs) may lead to a better prognosis. Herein, we report prodromal transient neurological symptoms that should raise clinical suspicion of CA with GAD-Abs. We initially identified a 70-year-old man who presented a first acute episode of vertigo, diplopia, and ataxia lasting 2 weeks. Two months later, he experienced a similar episode along with new-onset gaze-evoked nystagmus. After 4 months, downbeat nystagmus, left limb dysmetria, and gait ataxia progressively appeared, and an autoimmune CA was diagnosed based on the positivity of GAD-Abs in serum and cerebrospinal fluid (CSF). We searched retrospectively for similar presentations in a cohort of 31 patients diagnosed with CA and GAD-Abs. We found 11 (35.4%) patients (all women, median age 62 years; 8/11 [72.7%] with autoimmune comorbidities) with transient neurological symptoms antedating CA onset by a median of 3 months, including vertigo in 9 (81.8%; described as paroxysmal in 8) and fluctuating diplopia in 3 (27.3%) patients. The identification of transient neurological symptoms of unknown etiology, such as paroxysmal vertigo and fluctuating diplopia, should lead to GAD-Abs testing in serum and CSF, especially in patients with autoimmune comorbidities. |
| Databáze: | OpenAIRE |
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