• Michael P Malter, Christoph Helmstaedter, Horst Urbach, Angela Vincent, and Christian G Bien.
• Department of Epileptology, University of Bonn Medical Center, Bonn, Germany.
• Ann. Neurol. 2010 Apr 1; 67 (4): 470-8.

ObjectiveAntibodies to glutamic acid decarboxylase (GAD) have been described in a few patients with temporal lobe epilepsies consistent with limbic encephalitis (LE). We studied a cohort of patients with recent-onset temporal lobe epilepsy caused by LE to test for GAD antibody positivity and response to immunotherapies.MethodsOver a period of 3.75 years, 138 patients aged >or=18 years investigated at the Department of Epileptology, University of Bonn, for recent-onset epilepsy were prospectively collected and studied for cliniconeuroradiological features of LE, autoantibodies, and treatment responses.ResultsFifty-three adult patients fulfilled the criteria for LE: (1) limbic signs and symptoms for InterpretationHigh-titer GAD antibodies define a form of nonparaneoplastic LE. This is a chronic, nonremitting disorder and should be included in the differential diagnosis of patients with TLE and mediotemporal encephalitis. Therapeutic trials of other immunotherapies should be undertaken.

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