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首页> 外文期刊>Turk Neuroloji Dergisi >The Importance of Consultation Neurology: A Patient with Anti-Glutamic Acid Decarboxylase Antibody-Associated Cerebellar Ataxia Recognized in the Psychiatry Inpatient Clinic
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The Importance of Consultation Neurology: A Patient with Anti-Glutamic Acid Decarboxylase Antibody-Associated Cerebellar Ataxia Recognized in the Psychiatry Inpatient Clinic

机译：咨询神经病学的重要性：精神科住院患者中认识到抗谷氨酸脱羧酶抗体相关的小脑共济失调患者

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Neurologic processes associated with anti-glutamic acid decarboxylase antibodies (anti-GAD) are rare and difficult to diagnose. This disease group may be associated with other autoimmune diseases such as insulin-dependent diabetes mellitus (DM) and includes ‘stiff person syndrome’ (SPS), cerebellar ataxia, gluten ataxia, progressive encephalomyelitis with rigidity-myoclonus, refractory epilepsy-limbic encephalitis, and palatal myoclonus subheadings (1).A woman aged 25 years was evaluated during a consultation while she was hospitalized at the psychiatry clinic. Following an emotional trauma one week before, she reported anorexia, nausea-vomiting, dizziness, double vision, speech and gait disturbance that were added within days. The patient, who was unable to sit without support and kept her eyes closed, had dysarthria, chaotic eye movements, fixation difficulty, and distinct truncal ataxia. Complete blood count, blood biochemistry, thyroid function tests, and beta-human chorionic gonadotropin were within normal limits. Thiamine replacement treatment was initiated, and there were no abnormalities in electroencephalography and neuroimaging studies (brain computed tomography, unenhanced and enhanced brain magnetic resonance (MR) imaging, extracranial and intracranial MR angiography). A cerebrospinal fluid (CSF) investigation revealed 35 leukocytes/mm3, no atypical cells, normal biochemistry, an immunoglobulin (Ig) G index of 0.47, and positive oligoclonal bands (OCB). Antiviral therapy was initiated due to CSF pleocytosis. The patient’s serum immunoelectrophoresis was normal, and anti-thyroperoxidase, anti-thyroglobulin antibodies, vasculitic and infectious markers, malignancy screening and paraneoplastic antibodies (anti-Hu, anti-Yo, anti-Ri, anti-amphiphysin, anti-Tr, anti-parietal cell antibodies-2, anti-Ma, anti-CV2.1, anti-ANNA-3) were negative.
机译：与抗谷氨酸脱羧酶抗体（anti-GAD）相关的神经系统过程很少见且难以诊断。此疾病组可能与其他自身免疫性疾病相关，例如胰岛素依赖型糖尿病（DM），包括“僵硬人综合征”（SPS），小脑性共济失调，面筋性共济失调，进行性脑脊髓炎并伴有僵直性肌阵挛，难治性癫痫性肢体脑炎， pa骨肌阵挛小标题（1）。一名25岁的妇女在精神病医院住院期间接受咨询时接受了评估。一周前发生情感创伤后，她报告称厌食症，恶心呕吐，头晕，复视，言语和步态障碍在几天之内加重。该患者在没有支撑的情况下无法坐下并闭上眼睛，患有构音障碍，眼球混乱，注视困难和明显的躯干共济失调。全血细胞计数，血液生化，甲状腺功能检查和β-人绒毛膜促性腺激素均在正常范围内。开始硫胺素替代治疗，脑电图和神经影像学检查（脑计算机断层扫描，未增强和增强的脑磁共振（MR）成像，颅外和颅内MR血管造影）均无异常。脑脊液（CSF）调查显示35白细胞/ mm3，无非典型细胞，正常生化，免疫球蛋白（Ig）G指数为0.47，寡克隆阳性带（OCB）。由于CSF的胞吞作用开始了抗病毒治疗。患者的血清免疫电泳正常，抗甲状腺素过氧化物酶，抗甲状腺球蛋白抗体，血管和感染标志物，恶性肿瘤筛查和副肿瘤抗体（抗-Hu，抗-Yo，抗-Ri，抗两用药物，抗-Tr，抗-壁细胞抗体2，抗Ma，抗CV2.1，抗ANNA-3）均为阴性。

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