scholarly journals Cerebellar Ataxia Followed by Stiff Person Syndrome in a Patient with Anti-GAD Antibodies

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Sinali O. Seneviratne ◽  
Katherine A. Buzzard ◽  
Belinda Cruse ◽  
Mastura Monif
Keyword(s):  
Cerebellar Ataxia ◽  
Acid Decarboxylase ◽  
Stiff Person Syndrome ◽  
Gamma Aminobutyric Acid ◽  
Neurological Manifestations ◽  
Rare Occurrence ◽  
Gad Antibodies ◽  
Long Term Follow Up

Anti-GAD antibody syndrome is a result of the production of antibodies against glutamic acid decarboxylase (GAD), the main enzyme responsible for the production of gamma-aminobutyric acid (GABA). Several neurological manifestations including cerebellar ataxia and stiff person syndrome have been reported in association with anti-GAD antibodies. In this paper, we present a case of a young woman with anti-GAD antibodies who initially presented with cerebellar ataxia followed by stiff person syndrome three and a half years later. Having both cerebellar ataxia and stiff person syndrome is a rare occurrence in anti-GAD antibody syndrome. We emphasise the importance of long-term follow-up of patients with anti-GAD antibody syndrome, as delayed neurological manifestations can occur.

Tubercular Abscess of the Spleen in a Child: Conservative Management and Long-Term Follow-Up

2017 ◽  
Vol 13 (04) ◽  
pp. 316-318
Author(s):  
Vijai Williams ◽  
Sarvanan Chandrasekaran ◽  
Keerthivasan Seetharaman ◽  
Kushaljit Sodhi ◽  
Devi Dayal
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Splenic Abscess ◽  
Complete Healing ◽  
Rare Occurrence ◽  
Line Probe Assay ◽  
Rare Manifestation ◽  
Long Term Follow Up ◽  
Probe Assay

AbstractIsolated involvement of the spleen is a rare manifestation of childhood tuberculosis. The rare occurrence and presence of nonspecific clinical features often pose diagnostic challenges even in countries where tuberculosis is endemic. Splenectomy is often performed for establishing the diagnosis or achieving a cure in combination with antitubercular therapy (ATT). In this report, we describe a boy who presented with nonspecific symptoms and was detected to have a well-defined lesion in the spleen on ultrasonography. The diagnosis of tubercular splenic abscess was made after line probe assay for the detection of Mycobacterium tuberculosis and cytomorphology of the aspirated material. The tubercular abscess showed complete healing after 9 months of four-drug ATT.

Long-term follow-up of neurological manifestations in a boy with incontinentia pigmenti

2013 ◽  
Vol 172 (9) ◽  
pp. 1259-1262 ◽  
Author(s):  
Lucia Margari ◽  
Anna Linda Lamanna ◽  
Maura Buttiglione ◽  
Francesco Craig ◽  
Maria G. Petruzzelli ◽  
...  
Keyword(s):  
Incontinentia Pigmenti ◽  
Neurological Manifestations ◽  
Long Term Follow Up

Neurological Manifestations of Mycoplasma pneumoniae Infection in Hospitalized Children and Their Long-Term Follow-Up

2016 ◽  
Vol 47 (05) ◽  
pp. 308-317 ◽  
Author(s):  
Jessica Kammer ◽  
Stefan Ziesing ◽  
Lukas Davila ◽  
Eva Bültmann ◽  
Sabine Illsinger ◽  
...  
Keyword(s):  
Mycoplasma Pneumoniae ◽  
Hospitalized Children ◽  
Neurological Manifestations ◽  
Long Term Follow Up ◽  
Mycoplasma Pneumoniae Infection

scholarly journals Stiff Person Syndrome and Gluten Sensitivity

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1373
Author(s):  
Marios Hadjivassiliou ◽  
Panagiotis Zis ◽  
David S. Sanders ◽  
Nigel Hoggard ◽  
Ptolemaios G. Sarrigiannis
Keyword(s):  
Autoimmune Diseases ◽  
Axial Stiffness ◽  
Acid Decarboxylase ◽  
Gluten Sensitivity ◽  
Stiff Person Syndrome ◽  
Gluten Free ◽  
Serological Evidence ◽  
Gad Antibodies ◽  
The Mean

Stiff person syndrome (SPS) is a rare autoimmune disease characterised by axial stiffness and episodic painful spasms. It is associated with additional autoimmune diseases and cerebellar ataxia. Most patients with SPS have high levels of glutamic acid decarboxylase (GAD) antibodies. The aetiology of SPS remains unclear but autoimmunity is thought to play a major part. We have previously demonstrated overlap between anti-GAD ataxia and gluten sensitivity. We have also demonstrated the beneficial effect of a gluten-free diet (GFD) in patients with anti-GAD ataxia. Here, we describe our experience in the management of 20 patients with SPS. The mean age at symptom onset was 52 years. Additional autoimmune diseases were seen in 15/20. Nineteen of the 20 patients had serological evidence of gluten sensitivity and 6 had coeliac disease. Fourteen of the 15 patients who had brain imaging had evidence of cerebellar involvement. Twelve patients improved on GFD and in seven GFD alone was the only treatment required long term. Twelve patients had immunosuppression but only three remained on such medication. Gluten sensitivity plays an important part in the pathogenesis of SPS and GFD is an effective therapeutic intervention.

scholarly journals Neurological disorders associated with glutamic acid decarboxylase antibodies: a Brazilian series

2012 ◽  
Vol 70 (9) ◽  
pp. 657-661 ◽  
Author(s):  
Maurício Fernandes ◽  
Renato P. Munhoz ◽  
Paulo Eduardo Mestrinelli Carrilho ◽  
Walter O. Arruda ◽  
Paulo J. Lorenzoni ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Glutamic Acid ◽  
Cerebellar Ataxia ◽  
Glutamic Acid Decarboxylase ◽  
Neurological Disorders ◽  
Acid Decarboxylase ◽  
Stiff Person Syndrome ◽  
Gad Antibodies ◽  
Glutamic Acid Decarboxylase Antibodies

Neurological disorders associated with glutamic acid decarboxylase (GAD) antibodies are rare pleomorphic diseases of uncertain cause, of which stiff-person syndrome (SPS) is the best-known. Here, we described nine consecutive cases of neurological disorders associated with anti-GAD, including nine patients with SPS and three cases with cerebellar ataxia. Additionally, four had hypothyroidism, three epilepsy, two diabetes mellitus and two axial myoclonus.

scholarly journals Diffuse Leukoplakia of the Bladder Ostium-Sparing in Patient Treated with Leuprorelin for Breast Cancer

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Antonio Nacchia ◽  
Ferdinando di Giacomo ◽  
Arcangelo Di Cerbo ◽  
Massimo Dante Di Somma ◽  
Giuseppe Patitucci ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Urine Culture ◽  
Previous Treatment ◽  
Lateral Wall ◽  
Rare Occurrence ◽  
Left Lateral Wall ◽  
Long Term Follow Up

Case. A 55-year-old woman came to our attention in April 2020 referring haematuria, frequency and urgency. The patient referred previous treatment with leuprorelin 3.75 mg/2 ml for breast cancer three years ago. Urine culture was performed and resulted always negative for pathogens. Cystoscopy revealed a whitish plaque lesion on the fundus, dome, trigone, and left lateral wall of the bladder. Histology of the biopsy confirmed the diagnosis of leukoplakia of the bladder. The plan is to follow her up repeating a cystoscopy every three months and biopsy in 6 months. Literature search revealed very little information on pathogenesis and prognosis of this condition due to its rare occurrence. The main objective of our case study was to describe individual situation of a woman affected by diffuse leukoplakia of the bladder ostium-sparing with a previous treatment with leuprorelin 3.75 mg/2 ml for breast cancer and to show safety of follow-up by cystoscopy and biopsy. Conclusions. We showed a case of a woman treated with leuprorelin and with diffuse leukoplakia of the bladder. We support the recommended long-term follow-up and surveillance based on the literature review by cystoscopy with or without biopsy.

Stiff-person syndrome with acute recurrent peripheral vertigo: possible evidence of gamma aminobutyric acid as a neurotransmitter in the vestibular periphery

2007 ◽  
Vol 122 (6) ◽  
pp. 636-638 ◽  
Author(s):  
R Teggi ◽  
L O Piccioni ◽  
G Martino ◽  
C Bellini ◽  
M Bussi
Keyword(s):  
Glutamic Acid ◽  
Glutamic Acid Decarboxylase ◽  
Aminobutyric Acid ◽  
Acid Decarboxylase ◽  
Stiff Person Syndrome ◽  
Gamma Aminobutyric Acid ◽  
Vestibular Damage ◽  
Peripheral Vertigo

AbstractObjective:We report a case of a 58-year-old man suffering from stiff-person syndrome and recurrent peripheral vertigo.Method:A case report and a review of the recent literature on stiff-person syndrome are presented.Results:The patient presented with recurrent episodes of vertigo with a pure peripheral pattern and with concomitant episodes of burning muscle pain, muscle twitching, weight gain and fatigue, worsening with tension or stress that also occurred in periods without vertigo. Cochlear examinations only showed presbyacusis-like hearing loss. The diagnosis of stiff-person syndrome was made with electromyographic examination and from findings in the blood and cerebrospinal fluid of high titres of anti-glutamic acid decarboxylase (GAD67) autoantibodies. In a two-year follow-up period, therapy for stiff-person syndrome abolished episodes of both stiffness and vertigo.Conclusion:As far as we know, no other clinical case of acute vestibular damage with a possible correlation with anti-glutamic acid decarboxylase antibodies has been described. Peripheral vertigo possibly related to a lack of gamma aminobutyric acid underlines a possible role of gamma aminobutyric acid as a neurotransmitter in the peripheral vestibular system.

Dentate nucleus stimulation in a patient with cerebellar ataxia and tremor after cerebellar stroke: A long-term follow-up

2019 ◽  
Vol 60 ◽  
pp. 173-175 ◽  
Author(s):  
Rubens Gisbert Cury ◽  
Carina França ◽  
Egberto Reis Barbosa ◽  
Ricardo Galhardoni ◽  
Guilherme Lepski ◽  
...  
Keyword(s):  
Cerebellar Ataxia ◽  
Dentate Nucleus ◽  
Cerebellar Stroke ◽  
Long Term Follow Up

Therapy and prevention for mental health: What if mental diseases are mostly not brain disorders?

2019 ◽  
Vol 42 ◽  
Author(s):  
John P. A. Ioannidis
Keyword(s):  
Mental Health ◽  
Mental Disease ◽  
Brain Disorders ◽  
Social Stressors ◽  
Labor Education ◽  
Mental Diseases ◽  
Long Term Follow Up ◽  
Political Decisions

AbstractNeurobiology-based interventions for mental diseases and searches for useful biomarkers of treatment response have largely failed. Clinical trials should assess interventions related to environmental and social stressors, with long-term follow-up; social rather than biological endpoints; personalized outcomes; and suitable cluster, adaptive, and n-of-1 designs. Labor, education, financial, and other social/political decisions should be evaluated for their impacts on mental disease.

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