Abstract
Antibodies targeting the 65-kilodalton isoform of glutamic acid decarboxylase (GAD65) are implicated in several autoimmune neurologic disorders.1 Anti-GAD65 antibodies (GAD65-Abs) can be seen in healthy individuals, highlighting the importance of interpreting their significance in the appropriate clinical context.1 Classic neurologic presentations include stiff-person syndrome, cerebellar ataxia, limbic encephalitis, epilepsy, myelopathy, other brainstem manifestations, and extrapyramidal symptoms.1-3 A few cases of focal myoclonus have been described.2 There is one previous report of palatal myoclonus with normal brain MRI.4 We report a patient with GAD65-Abs with relapsing diplopia, cerebellar syndrome, and palatal myoclonus with hypertrophy of the inferior olivary nuclei (ION) seen on 1.5T MRI and a dentato-rubro-olivary pathway lesion on 7T MRI.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 273-275 |
| Number of pages | 3 |
| Journal | Neurology |
| Volume | 94 |
| Issue number | 6 |
| DOIs | |
| State | Published - Feb 11 2020 |
Funding
G. Macaron receives fellowship funding from the National Multiple Sclerosis Society Institutional Clinician Training Award ICT 0002 and has received fellowship funding from Biogen Fellowship Grant 6873-P-FEL. She has served on a scientific advisory board for Genentech. M. Willis has received speaking fees from Biogen, Novartis, Genzyme, and Ipsen. D. Ontaneda has received research support from National Multiple Sclerosis Society, NIH, Patient Centered Research Institute, Race to Erase MS Foundation, Genentech, and Genzyme. He has also received consulting fees from Biogen Idec, Genentech/Roche, Genzyme, and Merck. H. Fernandez has received research support from Acorda Therapeutics, Michael J. Fox Foundation, Movement Disorders Society, NIH/NINDS, Parkinson Study Group, Sunovion, but has no owner interest in any pharmaceutical company, honoraria from American Osteopathic Association, Cleveland Clinic, South Alabama Medical Science Foundation Thorax Clinical Communications, UMA Education, as a speaker in CME events, honoraria from Acorda Therapeutics, Denali Therapeutics, Pfizer, Partners Healthcare System (Parkinson Study Group), Sunovion Research and Development Trust as a consultant, Elsevier as the Editor-In-Chief of Parkinsonism and Related Disorders Journal, and royalty payments from Demos Publishing and Springer for serving as a book author/editor. The Cleveland Clinic has a contract with Teva for Dr.Fernandez’ role as a Co-Principal Investigator in SD-809/Austedo Tardive Dyskinesia global studies. Dr. Fernandez also serves as a member of the publication committee for Acorda Pharmaceuticals, Sunovion Pharmaceuticals but does not receive any personal compensation for this. S. Kim has reports no disclosures relevant to the manuscript. S. Jones has received travel and speaking fees from Siemens and IMRIS, speaking fees from Radnet and Saint Judes, research support and travel fees from MS PATHS, and research support from the NIH. E. Pioro has received clinical trial and research funding from NIH/CDC, and ALS Association. He has received consulting fees from Avanir Pharmaceuticals, Inc., biohaven Pharmaceuticals, Inc., Cytokinetics, Inc., ITF Pharma, Inc., MT Pharma America, Inc., and Otsuka America, Inc. J. Cohen has received personal compensation for consulting for Alkermes, Biogen, Convelo, EMD Serono, ERT, Gossamer Bio, Novartis, and Provaluate; speaking for Mylan and Synthon; and serving as an Editor of Multiple Sclerosis Journal. Go to https://n.neurology.org/lookup/doi/10.1212/WNL.0000000000008926 for full disclosures. Acknowledgment
ASJC Scopus subject areas
- Clinical Neurology