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Published on: November 23, 2013
Anti-GAD antibodies and periodic alternating nystagmus
Caroline Tilikete1, Alain Vighetto, Paul Trouillas
1Neuro-Ophthalmology Unit, Hôpital Neurologique, Hospices civils de Lyon, Bron, France. tilikete@lyon.inserm.fr
Background:
Autoantibodies directed against glutamic acid decarboxylase (GAD-Ab) have recently been described in a few patients with progressive cerebellar ataxia, suggesting an autoimmune physiopathologic mechanism.
Objective:
To determine the exact role of GAD-Ab and gamma-aminobutyric acid (GABA)-ergic neurotransmission in the pathogenesis of cerebellar ataxia.
Design:
Case report.
Setting:
University neurological hospital.
Patient:
We report the case of a patient with subacute cerebellar ataxia associated with GAD-Ab showing periodic alternating nystagmus (PAN).
Intervention:
Baclofen, a GABAergic medication, was given to the patient.
Main Outcome Measures:
Eye movement recording of spontaneous nystagmus and postrotatory vestibular responses.
Results:
Baclofen was effective in suppressing PAN and improving postrotatory vestibular responses but not for improving cerebellar ataxia.
Conclusion:
The presence of PAN and the response to baclofen provide a unique opportunity to suggest a direct role of GAD-Ab in cerebellar dysfunction in this patient.
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