Researchers at University Hospital of Geneva, Switzerland, report a case of glutamic acid decarboxylase autoantibodies (GADA)-related encephalitis in a 6-year-old girl and review the literature. She developed refractory seizures at age 25 months followed by mental regression and type 1 diabetes mellitus, in association with elevated plasma and CSF GADAs. A dramatic decrease in serum GADA levels was observed 2 weeks after plasmapheresis and was maintained by oral prednisone and 2 plasmapheresis sessions per week. At 8 years, her gait was normal and she could understand and speak short sentences, but seizures were only partially controlled. Only two previous reports were published, in 2002 and 2009. One child recovered completely within 3 months of disease onset, despite persistently high values of plasma GADA. [1]

COMMENT. The concept of epilepsy caused by autoantibodies to specific neuronal membrane proteins is a growing area of interest in epilepsy research [2]. Voltage-gated potassium channels, N-methyl-D-aspartate receptors, and glutamic acid decarboxylase are involved in some cases of limbic encephalitis. Patients whose seizures do not respond to conventional anticonvulsants should be tested for autoantibodies and considered for a trial of immunotherapy.