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ILAE type 3 hippocampal sclerosis in patients with anti-GAD-related epilepsy
Robert L Glover1, Lauren V DeNiro1, Patrick A Lasala1
1Department of Neurology (R.L.G., L.V.D., K.M.W., J.J.G., A.B.), Department of Neurological Surgery (P.A.L., K.M.W.), and Department of Pathology (K.M.W.), Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY.
Objective:
To describe the neuropathologic findings and clinical course of 2 patients who underwent temporal lobectomy for medically refractive epilepsy and were later found to have high anti-glutamic acid decarboxylase (GAD) concentrations.
Methods:
Small case series.
Results:
Neuropathologic examination of both patients revealed International League Against Epilepsy (ILAE) type 3 hippocampal sclerosis. Following surgery, both developed signs and symptoms of stiff person syndrome and later cerebellar ataxia. Laboratory studies demonstrated high concentrations of anti-GAD antibodies in both patients.
Conclusions:
These cases suggest that ILAE type 3 hippocampal sclerosis may be immunologically related to and may exist as part of a broader anti-GAD-related neurologic syndrome in some instances.
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