Psychiatric symptoms in anti glutamic acid decarboxylase associated limbic encephalitis in adults: a systematic review

Agathe Vrillon, Guilhem Carle, Giulia Berzero, Jérôme Honnorat, Gilles Huberfeld, Dimitri Psimaras, Carole Azuar

Research output: Contribution to journalReview articlepeer-review

Abstract

Autoimmune Limbic Encephalitis (LE) is a relatively new category of immune-mediated diseases with a wide range of neuropsychiatric symptoms. LE associated with Glutamic Acid Decarboxylase (GAD) antibodies is difficult to diagnose due to its possible atypical presentation with neuropsychiatric and behavioral features. We performed a systematic review of literature and retrieved 21 cases of anti GAD-associated LE with neuropsychiatric signs. Median age at onset was 27 years with a female predominance (81.0 %) and median diagnostic delay of 6 months. Clinical presentation included typical LE symptoms such as anterograde amnesia (95.2 %) and temporal lobe or tonico-clonic seizures (95.2 %). Psychiatric symptoms were described in 61.9 % of patients, presenting as anxiety, depressive symptoms, apathy and behavioral changes. Extra-limbic symptoms were present in 14.3 % of patients. No neoplasia associated was found. Some patients had poor epileptic, cognitive and psychiatric outcomes requiring prolonged immunosuppressive treatment. The description of the neuropsychiatric spectrum of anti-GAD LE and its specificities aims to improve our understanding of this entity, and may lead to earlier diagnosis as well as better outcome.

Original languageEnglish
Pages (from-to)128-137
Number of pages10
JournalNeurosci. Biobehav. Rev.
Volume119
DOIs
Publication statusE-pub ahead of print - Oct 3 2020

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