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High-throughput Flow Cytometry Cell-based Assay to Detect Antibodies to N-Methyl-D-aspartate Receptor or Dopamine-2 Receptor in Human Serum
Published on: November 23, 2013
GABA-B-receptor antibodies in paraneoplastic brainstem encephalitis
S Mundiyanapurath1, S Jarius, C Probst
1Department of Neurology, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany. sibu.mundiyanapurath@med.uni-heidelberg.de
Journal of Neuroimmunology
|May 1, 2013
Summary
Autoimmune encephalitis targeting Gamma-aminobutyric-acid B (GABA-B) receptors can present with diverse neurological symptoms. This paraneoplastic form, linked to esophageal carcinoma, improved with immunotherapy.
Area of Science:
- Neuroimmunology
- Autoimmune neurological disorders
Background:
- Gamma-aminobutyric-acid B (GABA-B)-receptor encephalitis is an emerging autoimmune central nervous system (CNS) disorder.
- Limbic encephalitis is the most common presentation.
Observation:
- A 63-year-old male presented with acute vertigo, nausea, vomiting, facial palsy, and dysarthria.
- The patient progressed to dysphagia, gait ataxia, and respiratory failure.
- Antibodies to GABA-B receptors were detected.
Findings:
- Treatment with intravenous methylprednisolone and plasma exchange led to a decline in GABA-B receptor antibodies.
- The patient showed clinical improvement and stabilization following treatment.
- Oesophageal carcinoma was identified as the underlying malignancy.
Implications:
- The spectrum of neurological manifestations in paraneoplastic anti-GABA-B-receptor encephalitis may be wider than previously understood.
- This case highlights the importance of considering broader neurological presentations and associated tumors in autoimmune encephalitis.
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