Antiglutamate acid decarboxylase seropositive brain stem encephalitis

BMJ Case Rep. 2023 Mar 10;16(3):e254026. doi: 10.1136/bcr-2022-254026.

Abstract

This is a case of a previously healthy female in her fourties presenting with a subacute presentation of bilateral horizontal gaze restriction, with bilateral lower motor facial palsy. The patient's daughter has type 1 diabetes. On investigation, the patient's MRI revealed a lesion in the dorsal medial pons. Cerebrospinal fluid analysis revealed albuminocytological dissociation, with a negative autoimmune panel. The patient was treated with intravenous immunoglobulin, and methylprednisolone for a total of 5 days and showed mild improvement. The patient had raised serum antiglutamic acid decarboxylase (anti-GAD) levels, and the final diagnosis of GAD seropositive brain stem encephalitis was made.

Keywords: neurology; neuroopthalmology.

Publication types

  • Case Reports

MeSH terms

  • Autoantibodies
  • Carboxy-Lyases*
  • Encephalitis* / diagnosis
  • Female
  • Glutamate Decarboxylase
  • Humans
  • Immunoglobulins, Intravenous
  • Magnetic Resonance Imaging
  • Pons

Substances

  • Immunoglobulins, Intravenous
  • Carboxy-Lyases
  • Glutamate Decarboxylase
  • Autoantibodies