Unusual clinical manifestation of Anti-GAD65 encephalitis in a patient with a background of epilepsy presented with seizure and altered mental status: A case report and literature review
Main Article Content
Keywords
autoimmune encephalitis, herpes encephalitis, anti-GAD, seizure, epilepsy, alcohol use disorder
Abstract
Background: A 67-year-old male with epilepsy and alcohol abuse disorder presented with neurologic impairment, severely altered mental status and onoff focal seizures. There was no response to the initial anti-epileptic treatment, infectious aetiologies were ruled out, and magnetic resonance imaging revealed unilateral signal changes. The patient was successfully treated clinically with intravenous immunoglobulin and high-dose methylprednisolone. Anti-GAD65 antibodies were found in the autoimmune encephalitis panel after discharge. This case demonstrates the importance of including autoimmune encephalitis in the differential diagnosis of a patient with altered sensorium after ruling out more common aetiologies in order to avoid treatment delays and improve prognosis.
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