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http://hdl.handle.net/2445/175883
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DC Field | Value | Language |
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dc.contributor.author | Falip, Mercè | - |
dc.contributor.author | Rodríguez Bel, Laura | - |
dc.contributor.author | Castañer, Sara | - |
dc.contributor.author | Sala Padró, Jacint | - |
dc.contributor.author | Miró, Júlia | - |
dc.contributor.author | Jaraba, Sónia | - |
dc.contributor.author | Casasnovas Pons, Carlos | - |
dc.contributor.author | Morandeira-Rego, Francisco | - |
dc.contributor.author | Berdejo, Javier | - |
dc.contributor.author | Carreño, Mar | - |
dc.date.accessioned | 2021-03-30T13:40:18Z | - |
dc.date.available | 2021-03-30T13:40:18Z | - |
dc.date.issued | 2019-01-09 | - |
dc.identifier.issn | 1664-2295 | - |
dc.identifier.uri | http://hdl.handle.net/2445/175883 | - |
dc.description.abstract | Background: Antibodies to glutamic acid decarboxylase (GAD ab) have been found in patients with limbic encephalitis (LE) and chronic pharmacoresistant focal epilepsy (FE). The objectives of the study were to: (1) analyze the clinical and neuroimaging course of patients with FE+GAD ab, (2) compare these characteristics with a control group, and (3) describe the most affected cerebral areas with structural and functional imaging. Methods: Patients with FE + high titers of GAD ab and a follow-up of at least 5 years were selected. Titers of serum GAD ab exceeding 2,000 UI/ml were considered high. Evolutive clinical and radiological characteristics were studied in comparison to two different control groups: patients with bilateral or with unilateral mesial temporal sclerosis (BMTS or UMTS) of a non-autoimmune origin. Results: A group of 13 patients and 17 controls were included (8 BMTS, 9 UMTS). The most frequent focal aware seizures (FAS) reported by patients were psychic (5/13: 33%). Somatosensorial, motor, and visual FAS (4/13:32%) (p: 0.045), musicogenic reflex seizures (MRS), and a previous history of cardiac syncope were reported only patients (2/13:16% each) (p: NS). Comparing EEG characteristics between patients and controls, a more widespread distribution of interictal epileptiform discharges (IED) was observed in FE+ GAD ab patients than in controls (p:0.01). Rhythmic delta activity was observed in all controls in anterior temporal lobes while in patients this was less frequent (p: 0.001). No IED, even in 24 h cVEEG, was seen in 6 patients (46%).First MRI was normal in 4/5 (75%) patients. During the follow-up mesial temporal lobe (MTsL) sclerosis was observed in 5/8 (62%) of patients. All patients had abnormal FDG-PET study. MTL hypometabolism was observed in 10/11 (91%) patients, being bilateral in 7/11 (63%). In controls, this was observed in 16/17 (94%), and it was bilateral in 8/17 (47%) (p: NS). Insular hypometabolism was observed in 5/11 (45%) patients (P:0.002). Conclusions: Clinical, EEG, and FDG-PET findings in FE+GAD ab suggest a widespread disease not restricted to the temporal lobe. Progressive MTL sclerosis may be observed during follow-up. In comparison to what is found in patients with non-autoimmune MTL epilepsy, insular hypometabolism is observed only in patients with GAD ab, so it may be an important diagnostic clue. | - |
dc.format.extent | 12 p. | - |
dc.format.mimetype | application/pdf | - |
dc.language.iso | eng | - |
dc.publisher | Frontiers Media | - |
dc.relation.isformatof | Reproducció del document publicat a: https://doi.org/10.3389/fneur.2018.01143 | - |
dc.relation.ispartof | Frontiers In Neurology, 2019, vol. 9 | - |
dc.relation.uri | https://doi.org/10.3389/fneur.2018.01143 | - |
dc.rights | cc-by (c) Falip, Mercè et al., 2019 | - |
dc.rights.uri | http://creativecommons.org/licenses/by/3.0/es | - |
dc.source | Articles publicats en revistes (Ciències Clíniques) | - |
dc.subject.classification | Epilèpsia | - |
dc.subject.classification | Hipocamp (Cervell) | - |
dc.subject.classification | Sistema límbic | - |
dc.subject.other | Epilepsy | - |
dc.subject.other | Hippocampus (Brain) | - |
dc.subject.other | Limbic system | - |
dc.title | Hippocampus and insula are targets in epileptic patients with glutamic acid decarboxylase antibodies | - |
dc.type | info:eu-repo/semantics/article | - |
dc.type | info:eu-repo/semantics/publishedVersion | - |
dc.identifier.idgrec | 709055 | - |
dc.date.updated | 2021-03-30T13:40:18Z | - |
dc.rights.accessRights | info:eu-repo/semantics/openAccess | - |
dc.identifier.pmid | 30687213 | - |
Appears in Collections: | Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL)) Articles publicats en revistes (Ciències Clíniques) |
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709055.pdf | 2.13 MB | Adobe PDF | View/Open |
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