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
Pharmacy Practice
Aymen Abbas1Internal Medicine Department, Sheikh Khalifa Medical City, College of Medicine- University of Sharjah, Sharjah, Abu Dhabi, United Arab Emirates.
Yousef Alabrach1Internal Medicine Department, Sheikh Khalifa Medical City, College of Medicine- University of Sharjah, Sharjah, Abu Dhabi, United Arab Emirates.
Tajammal Zahoor2Internal Medicine Department, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates.
Saryia Adra3College of Medicine, University of Sharjah, Sharjah, United Arab Emirates.
Hiba Jawdat Barqawi4Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates., 5Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah 27272, United Arab Emirates.
Eman Abu-Gharbieh4Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates., 5Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah 27272, United Arab Emirates., 6School of Pharmacy, The University of Jordan, Amman 11942, Jordan.
Background: A 67-year-old male with epilepsy and alcohol abuse disorder presented with neurologic impairment, severely altered mental status and on-off 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.
