抗谷氨酸脫羧酶 65 抗體相關癲癇發作的研究進展_Journal of Epilepsy

Authors：

樊雪梅 , 李鑫鑫 , 黃賢會 ,  劉松巖

吉林大學中日聯誼醫院神經內科（長春 130033）;

Corresponding?author：

劉松巖, Email: Liu_sy@jlu.edu.cn

Keywords：

DOI：

10.7507/2096-0247.20210038

Video：

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癲癇發作是一系列免疫介導的神經系統疾病譜的一部分，隨著神經免疫學的發展和抗神經元抗體檢測技術的提高，自身免疫性腦炎（Autoimmune encephalitis，AE）相關抗體介導的癲癇發作比以往認為的更加普遍，抗谷氨酸脫羧酶（Glutamic acid decarboxylase，GAD）65 抗體也是成人不明原因的藥物難治性癲癇患者中常檢測到的抗體之一。目前，國內對于抗 GAD65 抗體相關癲癇發作研究較少，臨床醫生對其缺乏進一步的認識，使得臨床上可能存在漏診，患者的病情未能得到及時的治療。文章結合國內外最新研究，對抗 GAD65 抗體相關癲癇發作的流行病學、病理生理學、臨床表現、治療及預后方面做一綜述，為臨床診治提供參考。

Citation： 樊雪梅, 李鑫鑫, 黃賢會, 劉松巖. 抗谷氨酸脫羧酶 65 抗體相關癲癇發作的研究進展. Journal of Epilepsy, 2021, 7(3): 246-251. doi: 10.7507/2096-0247.20210038 Copy

1.	Steriade C, Britton J, Dale R, et al. Acute symptomatic seizures secondary to autoimmune encephalitis and autoimmune associated epilepsy: Conceptual definitions. Epilepsia, 2020, 61(7): 1341-1351.
2.	Malter MP, Helmstaedter C, Urbach H, et al. Antibodies to glutamic acid decarboxylase de?ne a form of limbic encephalitis. Ann Neurol, 2010, 67: 470-478.
3.	Dubey D, Alqallaf A, Hays R, et al. Neurologicalauto an-tibody prevalence in epilepsy of unknown etiology. JAMANeurol, 2017, 74: 397-402.
4.	Lilleker JB, Biswas V, Mohanraj R. Glutamic acid decarboxylase (GAD) antibodies in epilepsy: diagnostic yield and therapeutic implications. Seizure, 2014, 23: 598-602.
5.	McKnight K, Jiang Y, Hart Y, et al. Serum antibodies in epilepsy and seizure-associated disorders. Neurology, 2005, 65(11): 1730-1736.
6.	Reetz A, Solimena M, Matteoli M, et al. GABA and pancreatic beta-cells: colocalization of glutamic acid decarboxylase (GAD) and GABA with synaptic-like microvesicles suggests their role in GABA storage and secretion. EMBO J, 1991, 10: 1275-1284.
7.	Kass I, Hoke DE, Costa MG, et al. Cofactor-dependent conformational heterogeneity of GAD65 and its role in autoimmunity and neurotransmitter homeostasis. Proc Natl Acad Sci USA, 2014, 111(25): E2524-2529.
8.	Fenalti G, Hampe CS, Arafat Y; et al. COOH-terminal clustering of autoantibody and T-cell determinants on the structure of GAD65 provide insights into the molecular basis of autoreactivity. Diabetes, 2008, 57(5): 1293-1301.
9.	Fenalti G, Buckle AM. Structural biology of the GAD autoantigen. Autoimmun Rev, 2010, 9(3): 148-152.
10.	Ali F, Rowley M, JayakrishnanB, et al. Stiff-person syndrome (SPS) and anti-GAD-related CNS degenerations: protean additions to the autoimmune central neuropathies. J Autoimmun, 2011, 37: 79-87.
11.	Richter W, Shi Y, Baekkeskov S. Autoreactive epitopes defined by diabetes-associated human monoclonal antibodies are localized in the middle and C-terminal domains of the smaller form of glutamate decarboxylase. Proc Natl Acad Sci USA, 1993, 90: 2832-2836.
12.	Petit-Pedrol M, Sabater L, Saiz A, et al. Antibodies to inhibitory synaptic proteins in neurological syndromes associated with glutamic acid decarboxylase autoimmunity. PLoS One, 2015, 10: e0121364.
13.	Xinxin Li, Qi Guo, Songyan Liu, et al. Immune-mediated epilepsy with GAD65 antibodies. J Neuroimmunol, 2020, 341: 577189.
14.	Ahmad Daif, RimasV Lukas, Naoum P, et al. Antiglutamic acid decarboxylase 65(GAD65)antibody-associated epilepsy. Epilepsy Behav, 2018, 80: 331-336.
15.	Bien CG, Vincent A, Barnett MH, et al. Immunopathology of autoantibody-associated encephalitides: clues for pathogenesis. Brain, 2012, 135: 1622-1638.
16.	Waterhouse NJ, Sutton VR, Sedelies KA, et al. Cytotoxic T lymphocyte-induced killing in the absence of granzymes A and B is unique and distinct from both apoptosis and perforin-dependent lysis. J Cell Biol, 2006, 173: 133-144.
17.	Meuth SG, Herrmann AM, Simon OJ, et al. Cytotoxic CD8+ T cell-neuron interactions: perforin-dependent electrical silencing precedes but is not causally linked to neuronal cell death. J Neurosci, 2009, 29: 15397-15409.
18.	Widman G, Golombeck K, Hautzel H, et al. Treating a GAD65 antibody-associated limbic encephalitis with Basiliximab: a case study. Front Neurol, 2015, 6: 167.
19.	Vogrig A, Joubert B, André-ObadiaN, et al. Seizure specificities in patients with antibody-mediated autoimmune encephalitis. Epilepsia, 2019, 60(8): 1508-1525.
20.	Errichiello L, Perruolo G, Pascarella A, et al. Autoantibodies to glutamic acid decarboxylase (GAD) in focal and generalized epilepsy: a study on 233 patients. J Neuroimmunol, 2009, 211: 120-123.
21.	Bien CG, Urbach H, Schramm J, et al. Limbic encephalitis as a precipitating event in adult-onset temporal lobe epilepsy. Neurology, 2007, 69: 1236-1244.
22.	劉丹丹, 邵曉秋譯; 吳遜, 關鴻志審. 繼發于自身免疫性腦炎的急性癥狀性發作和自身免疫相關癲癇: 概念性定義. 癲癇雜志, 2020, 9(6): 443-450.
23.	徐雯, 苗晶, 白晶, 等. 抗谷氨酸脫羧酶(GAD65)抗體相關腦炎 1 例報告并文獻復習. 中風與神經病學雜志, 2019, 2(36): 165-166.
24.	余年, 王凌玲, 苗愛亮, 等. 抗谷氨酸脫羧酶抗體陽性自身免疫性腦炎三例臨床特征分析. 中國神經免疫學和神經病學雜志, 2020, 3(27): 122-128.
25.	王亮. 22 例自身免疫性癲癇的臨床特征. 河北醫科大學碩士學位論文. 2020.
26.	BastienJoubert, AudeBelbezier, Julie Haesebaert, et al. Long-term outcomes in temporal lobe epilepsy with glutamate decarboxylase antibodies. Journal of Neurology, 2020, 267(7): 2083-2089.
27.	李承玉, 劉丹丹, 邵曉秋, 等. 谷氨酸脫羧酶 65 抗體相關自身免疫性癲癇的臨床、影像學和腦電圖特征. 第八屆CEEA國際癲癇論壇, 2019.
28.	王小鵬, 韓曙光, 唐海, 等. 抗 GAD65 抗體腦炎的臨床特點. 國際感染病學(電子版), 2019, 8(04): 128-129.
29.	Falip M, Rodriguez-Bel L, Casta?erS, et al. Musicogenic reflex seizures in epilepsy with glutamic acid decarbocylase antibodies. ActaNeurolScand, 2018, 137(2): 272-276.
30.	Kammeyer R, Piquet AL. Multiple co-existing antibodies in autoimmune en- cephalitis: a case and review of the literature. J Neuroimmuno, 2019, 337: 577084.
31.	Gagnon MM, Savard M, Mourabit Amari K. Refractory status epilepticus and autoimmune encephalitis with GABAAR and GAD65 antibodies: a case report. Seizure, 2016, 37: 25-27.
32.	H?ftberger R, Titulaer MJ, Sabater L, et al. Encephalitis and GABAB receptor antibodies: novel findings in a new case series of 20 patients. Neurology, 2013, 81(17): 1500-1506.
33.	樊雪梅, 劉松巖, 黃麗敏, 等. 抗富含亮氨酸膠質瘤失活蛋白 1、谷氨酸脫羧酶 65 抗體雙重陽性自身免疫性腦炎并白癜風一例. 中華神經科雜志, 2020, 53(10): 810-813.
34.	Ari?o H, H?ftberger R, Gresa-Arribas N, et al. Paraneoplastic neurological syndromes and glutamic acid decarboxylase antibodies. JAMA Neurol, 2015, 72(8): 874-881.
35.	Zekeridou A, Majed M, HeliopoulosI, et al. Paraneoplastic autoimmunity and small-cell lung cancer: Neurological and serological accompaniments. Thorac Cancer, 2019, 10(4): 1001-1004.
36.	McKeon A, Tracy JA. GAD65 neurological autoimmunity. Muscle Nerve, 2017, 56(1): 15-27.
37.	Pittock S J, Kryzer T J, Lennon V A, et al. Paraneoplastic antibodies coexist and pre- dict cancer, not neurological syndrome. Ann Neurol, 2004, 56(5): 715-719.
38.	Gagnon MM, Savard M. Limbic encephalitis associated with GAD65 antibodies: brief review of the relevant literature. Can J Neurol Sci, 2016, 43(4): 486-493.
39.	Ren HT, Liu HQ, Qu T, et al. Autoimmune encephalitis associated with vitiligo? J Neuroimmunol, 2017, 310: 14-16.
40.	Liimatainen S, et al. Clinical significance of glutamic acid decarboxylase antibodies in patients with epilepsy. Epilepsia, 2010, 51(5): 760-767.
41.	Quek AM, Britton JW, McKeon A, et al. Autoimmune epilepsy: clinical characteristics and response to immunotherapy. Arch Neurol, 2012, 69(5): 582-593.
42.	Zhao J, Wang C, Xu X, et al. Coexistence of autoimmune encephalitis and other systemic autoimmune diseases. Front Neurol, 2019, 10: 1142.
43.	Saiz A, Blanco Y, Sabater L, et al. Spectrumof neurological syndromes associated with glutamic acid decarboxylase antibodies: diagnostic clues for this association. Brain, 2008, 131: 2553-2563.
44.	Dalakas MC, Li M, FujiiM, et al. Stiff person syndrome: quantification, specificity, and intrathecal synthesis of GAD65 antibodies. Neurology, 2001, 57(5): 780-784.
45.	FauserS, UttnerI, Ari?o H, et al. Long latency between GAD-antibody detection and development of limbic encephalitis - a case report. BMC Neurol, 2015, 15(1): 177.
46.	KwanP, Sills GJ, Kelly K, et al. Glutamic acid decarboxylase autoantibodies in controlled and uncontrolled epilepsy: a pilot study. Epilepsy Res, 2000, 42: 191-195.
47.	Nociti V, Frisullo G, Tartaglione T, et al. Refractory generalized seizures and cerebellar ataxia associated with anti-GAD antibodies responsive to immunosuppressive treatment. Eur J Neurol, 2010, 17: e5.
48.	Budhram A, Leung A, Nicolle MW, et al. Diagnosing autoimmune limbic encephalitis. CMAJ, 2019, 191(19): E529-E534.
49.	Husari KS, Dubey D. Autoimmune epilepsy. Neurotherapeutics, 2019, 16(3): 685-702.
50.	Farooqi MS, Lai Y, Lancaster E, et al. Therapeutic plasma exchange and immunosuppressive therapy in a patient with anti-GAD antibody-related epilepsy: quantification of the antibody response. J Clin Apher, 2015, 30(1): 8-14.
51.	Dubey D, Konikkara J, Modur PN, et al. Effectiveness of multimodality treatment for autoimmune limbic epilepsy. Epileptic Disord, 2014, 16(4): 494-499.
52.	Blanc F, Ruppert E, Kleitz C, et al. Acute limbic encephalitis and glutamic acid decarboxylase antibodies: a reality? J Neurol Sci, 2009, 287: 69-71.
53.	Vulliemoz S, Vanini G, Truffert A, et al. Epilepsy and cerebellar ataxia associated with anti-glutamic acid decarboxylase antibodies. J Neurol Neurosurg Psychiatry, 2007, 78: 187-189.
54.	Iorio R, Assenza G, Tombini M, et al. The detection of neural autoantibodies in patients with antiepileptic-drug-resistant epilepsy predicts response to immunotherapy. European Journal of Neurology, 2015, 22(1): 70-78.
55.	Khawaja AM, Vines BL, Miller DW, et al. Refractory status epilepticus and glutamic acid decarboxylase antibodies in adults: presentation, treatment and outcomes. Epileptic Disord, 2016, 18: 34-43.
56.	Crom WR, Glynn-Barnhart AM, Rodman JH, et al. Pharmacokinetics of anticancer drugs in children. Clin Pharmacokinet, 1987, 12: 168-213.
57.	Holzer FJ, Rossetti AO, Heritier-Barras AC, et al. Antibody-mediated status epilepticus: a retrospective multicenter survey. Eur Neurol, 2012, 68: 310-317.
58.	Dubey D, Farzal Z, Hays R, et al. Evaluation of positive and negative predictors of seizure outcomes among patients with immune-mediated epilepsy: a meta-analysis. Therapeutic Advances in Neurological Disorders, 2016, 9(5): 369-377.
59.	Blum S, Dionisio S. Refractory epilepsy secondary to anti-GAD encephalitis treated with DBS post SEEG evaluation: a novel case report based on stimulation findings. Epileptic Disord, 2018, 20(5): 451-456.
60.	Feyissa AM, Mirro EA, Wabulya A, et al. Brain-responsive neurostimulation treatment in patients with GAD65 antibody-associated autoimmune mesial temporal lobe epilepsy. Epilepsia Open, 2020, 5(2): 307-313.

1. Steriade C, Britton J, Dale R, et al. Acute symptomatic seizures secondary to autoimmune encephalitis and autoimmune associated epilepsy: Conceptual definitions. Epilepsia, 2020, 61(7): 1341-1351.
2. Malter MP, Helmstaedter C, Urbach H, et al. Antibodies to glutamic acid decarboxylase de?ne a form of limbic encephalitis. Ann Neurol, 2010, 67: 470-478.
3. Dubey D, Alqallaf A, Hays R, et al. Neurologicalauto an-tibody prevalence in epilepsy of unknown etiology. JAMANeurol, 2017, 74: 397-402.
4. Lilleker JB, Biswas V, Mohanraj R. Glutamic acid decarboxylase (GAD) antibodies in epilepsy: diagnostic yield and therapeutic implications. Seizure, 2014, 23: 598-602.
5. McKnight K, Jiang Y, Hart Y, et al. Serum antibodies in epilepsy and seizure-associated disorders. Neurology, 2005, 65(11): 1730-1736.
6. Reetz A, Solimena M, Matteoli M, et al. GABA and pancreatic beta-cells: colocalization of glutamic acid decarboxylase (GAD) and GABA with synaptic-like microvesicles suggests their role in GABA storage and secretion. EMBO J, 1991, 10: 1275-1284.
7. Kass I, Hoke DE, Costa MG, et al. Cofactor-dependent conformational heterogeneity of GAD65 and its role in autoimmunity and neurotransmitter homeostasis. Proc Natl Acad Sci USA, 2014, 111(25): E2524-2529.
8. Fenalti G, Hampe CS, Arafat Y; et al. COOH-terminal clustering of autoantibody and T-cell determinants on the structure of GAD65 provide insights into the molecular basis of autoreactivity. Diabetes, 2008, 57(5): 1293-1301.
9. Fenalti G, Buckle AM. Structural biology of the GAD autoantigen. Autoimmun Rev, 2010, 9(3): 148-152.
10. Ali F, Rowley M, JayakrishnanB, et al. Stiff-person syndrome (SPS) and anti-GAD-related CNS degenerations: protean additions to the autoimmune central neuropathies. J Autoimmun, 2011, 37: 79-87.
11. Richter W, Shi Y, Baekkeskov S. Autoreactive epitopes defined by diabetes-associated human monoclonal antibodies are localized in the middle and C-terminal domains of the smaller form of glutamate decarboxylase. Proc Natl Acad Sci USA, 1993, 90: 2832-2836.
12. Petit-Pedrol M, Sabater L, Saiz A, et al. Antibodies to inhibitory synaptic proteins in neurological syndromes associated with glutamic acid decarboxylase autoimmunity. PLoS One, 2015, 10: e0121364.
13. Xinxin Li, Qi Guo, Songyan Liu, et al. Immune-mediated epilepsy with GAD65 antibodies. J Neuroimmunol, 2020, 341: 577189.
14. Ahmad Daif, RimasV Lukas, Naoum P, et al. Antiglutamic acid decarboxylase 65(GAD65)antibody-associated epilepsy. Epilepsy Behav, 2018, 80: 331-336.
15. Bien CG, Vincent A, Barnett MH, et al. Immunopathology of autoantibody-associated encephalitides: clues for pathogenesis. Brain, 2012, 135: 1622-1638.
16. Waterhouse NJ, Sutton VR, Sedelies KA, et al. Cytotoxic T lymphocyte-induced killing in the absence of granzymes A and B is unique and distinct from both apoptosis and perforin-dependent lysis. J Cell Biol, 2006, 173: 133-144.
17. Meuth SG, Herrmann AM, Simon OJ, et al. Cytotoxic CD8+ T cell-neuron interactions: perforin-dependent electrical silencing precedes but is not causally linked to neuronal cell death. J Neurosci, 2009, 29: 15397-15409.
18. Widman G, Golombeck K, Hautzel H, et al. Treating a GAD65 antibody-associated limbic encephalitis with Basiliximab: a case study. Front Neurol, 2015, 6: 167.
19. Vogrig A, Joubert B, André-ObadiaN, et al. Seizure specificities in patients with antibody-mediated autoimmune encephalitis. Epilepsia, 2019, 60(8): 1508-1525.
20. Errichiello L, Perruolo G, Pascarella A, et al. Autoantibodies to glutamic acid decarboxylase (GAD) in focal and generalized epilepsy: a study on 233 patients. J Neuroimmunol, 2009, 211: 120-123.
21. Bien CG, Urbach H, Schramm J, et al. Limbic encephalitis as a precipitating event in adult-onset temporal lobe epilepsy. Neurology, 2007, 69: 1236-1244.
22. 劉丹丹, 邵曉秋譯; 吳遜, 關鴻志審. 繼發于自身免疫性腦炎的急性癥狀性發作和自身免疫相關癲癇: 概念性定義. 癲癇雜志, 2020, 9(6): 443-450.
23. 徐雯, 苗晶, 白晶, 等. 抗谷氨酸脫羧酶(GAD65)抗體相關腦炎 1 例報告并文獻復習. 中風與神經病學雜志, 2019, 2(36): 165-166.
24. 余年, 王凌玲, 苗愛亮, 等. 抗谷氨酸脫羧酶抗體陽性自身免疫性腦炎三例臨床特征分析. 中國神經免疫學和神經病學雜志, 2020, 3(27): 122-128.
25. 王亮. 22 例自身免疫性癲癇的臨床特征. 河北醫科大學碩士學位論文. 2020.
26. BastienJoubert, AudeBelbezier, Julie Haesebaert, et al. Long-term outcomes in temporal lobe epilepsy with glutamate decarboxylase antibodies. Journal of Neurology, 2020, 267(7): 2083-2089.
27. 李承玉, 劉丹丹, 邵曉秋, 等. 谷氨酸脫羧酶 65 抗體相關自身免疫性癲癇的臨床、影像學和腦電圖特征. 第八屆CEEA國際癲癇論壇, 2019.
28. 王小鵬, 韓曙光, 唐海, 等. 抗 GAD65 抗體腦炎的臨床特點. 國際感染病學(電子版), 2019, 8(04): 128-129.
29. Falip M, Rodriguez-Bel L, Casta?erS, et al. Musicogenic reflex seizures in epilepsy with glutamic acid decarbocylase antibodies. ActaNeurolScand, 2018, 137(2): 272-276.
30. Kammeyer R, Piquet AL. Multiple co-existing antibodies in autoimmune en- cephalitis: a case and review of the literature. J Neuroimmuno, 2019, 337: 577084.
31. Gagnon MM, Savard M, Mourabit Amari K. Refractory status epilepticus and autoimmune encephalitis with GABAAR and GAD65 antibodies: a case report. Seizure, 2016, 37: 25-27.
32. H?ftberger R, Titulaer MJ, Sabater L, et al. Encephalitis and GABAB receptor antibodies: novel findings in a new case series of 20 patients. Neurology, 2013, 81(17): 1500-1506.
33. 樊雪梅, 劉松巖, 黃麗敏, 等. 抗富含亮氨酸膠質瘤失活蛋白 1、谷氨酸脫羧酶 65 抗體雙重陽性自身免疫性腦炎并白癜風一例. 中華神經科雜志, 2020, 53(10): 810-813.
34. Ari?o H, H?ftberger R, Gresa-Arribas N, et al. Paraneoplastic neurological syndromes and glutamic acid decarboxylase antibodies. JAMA Neurol, 2015, 72(8): 874-881.
35. Zekeridou A, Majed M, HeliopoulosI, et al. Paraneoplastic autoimmunity and small-cell lung cancer: Neurological and serological accompaniments. Thorac Cancer, 2019, 10(4): 1001-1004.
36. McKeon A, Tracy JA. GAD65 neurological autoimmunity. Muscle Nerve, 2017, 56(1): 15-27.
37. Pittock S J, Kryzer T J, Lennon V A, et al. Paraneoplastic antibodies coexist and pre- dict cancer, not neurological syndrome. Ann Neurol, 2004, 56(5): 715-719.
38. Gagnon MM, Savard M. Limbic encephalitis associated with GAD65 antibodies: brief review of the relevant literature. Can J Neurol Sci, 2016, 43(4): 486-493.
39. Ren HT, Liu HQ, Qu T, et al. Autoimmune encephalitis associated with vitiligo? J Neuroimmunol, 2017, 310: 14-16.
40. Liimatainen S, et al. Clinical significance of glutamic acid decarboxylase antibodies in patients with epilepsy. Epilepsia, 2010, 51(5): 760-767.
41. Quek AM, Britton JW, McKeon A, et al. Autoimmune epilepsy: clinical characteristics and response to immunotherapy. Arch Neurol, 2012, 69(5): 582-593.
42. Zhao J, Wang C, Xu X, et al. Coexistence of autoimmune encephalitis and other systemic autoimmune diseases. Front Neurol, 2019, 10: 1142.
43. Saiz A, Blanco Y, Sabater L, et al. Spectrumof neurological syndromes associated with glutamic acid decarboxylase antibodies: diagnostic clues for this association. Brain, 2008, 131: 2553-2563.
44. Dalakas MC, Li M, FujiiM, et al. Stiff person syndrome: quantification, specificity, and intrathecal synthesis of GAD65 antibodies. Neurology, 2001, 57(5): 780-784.
45. FauserS, UttnerI, Ari?o H, et al. Long latency between GAD-antibody detection and development of limbic encephalitis - a case report. BMC Neurol, 2015, 15(1): 177.
46. KwanP, Sills GJ, Kelly K, et al. Glutamic acid decarboxylase autoantibodies in controlled and uncontrolled epilepsy: a pilot study. Epilepsy Res, 2000, 42: 191-195.
47. Nociti V, Frisullo G, Tartaglione T, et al. Refractory generalized seizures and cerebellar ataxia associated with anti-GAD antibodies responsive to immunosuppressive treatment. Eur J Neurol, 2010, 17: e5.
48. Budhram A, Leung A, Nicolle MW, et al. Diagnosing autoimmune limbic encephalitis. CMAJ, 2019, 191(19): E529-E534.
49. Husari KS, Dubey D. Autoimmune epilepsy. Neurotherapeutics, 2019, 16(3): 685-702.
50. Farooqi MS, Lai Y, Lancaster E, et al. Therapeutic plasma exchange and immunosuppressive therapy in a patient with anti-GAD antibody-related epilepsy: quantification of the antibody response. J Clin Apher, 2015, 30(1): 8-14.
51. Dubey D, Konikkara J, Modur PN, et al. Effectiveness of multimodality treatment for autoimmune limbic epilepsy. Epileptic Disord, 2014, 16(4): 494-499.
52. Blanc F, Ruppert E, Kleitz C, et al. Acute limbic encephalitis and glutamic acid decarboxylase antibodies: a reality? J Neurol Sci, 2009, 287: 69-71.
53. Vulliemoz S, Vanini G, Truffert A, et al. Epilepsy and cerebellar ataxia associated with anti-glutamic acid decarboxylase antibodies. J Neurol Neurosurg Psychiatry, 2007, 78: 187-189.
54. Iorio R, Assenza G, Tombini M, et al. The detection of neural autoantibodies in patients with antiepileptic-drug-resistant epilepsy predicts response to immunotherapy. European Journal of Neurology, 2015, 22(1): 70-78.
55. Khawaja AM, Vines BL, Miller DW, et al. Refractory status epilepticus and glutamic acid decarboxylase antibodies in adults: presentation, treatment and outcomes. Epileptic Disord, 2016, 18: 34-43.
56. Crom WR, Glynn-Barnhart AM, Rodman JH, et al. Pharmacokinetics of anticancer drugs in children. Clin Pharmacokinet, 1987, 12: 168-213.
57. Holzer FJ, Rossetti AO, Heritier-Barras AC, et al. Antibody-mediated status epilepticus: a retrospective multicenter survey. Eur Neurol, 2012, 68: 310-317.
58. Dubey D, Farzal Z, Hays R, et al. Evaluation of positive and negative predictors of seizure outcomes among patients with immune-mediated epilepsy: a meta-analysis. Therapeutic Advances in Neurological Disorders, 2016, 9(5): 369-377.
59. Blum S, Dionisio S. Refractory epilepsy secondary to anti-GAD encephalitis treated with DBS post SEEG evaluation: a novel case report based on stimulation findings. Epileptic Disord, 2018, 20(5): 451-456.
60. Feyissa AM, Mirro EA, Wabulya A, et al. Brain-responsive neurostimulation treatment in patients with GAD65 antibody-associated autoimmune mesial temporal lobe epilepsy. Epilepsia Open, 2020, 5(2): 307-313.

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