AUTHOR=Rajmohan Ravi , Baveja Shivali , Nguyen Dai , Shah Eshita , Sy Michael , Attaripour Sanaz , Swope David 

TITLE=Case report: Approaches to treatment-refractory and super-refractory glutamic acid decarboxylase antibody-spectrum disorders

JOURNAL=Frontiers in Immunology

VOLUME=Volume 14 - 2023

YEAR=2024

URL=https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2023.1297340

DOI=10.3389/fimmu.2023.1297340

ISSN=1664-3224

ABSTRACT=Background: GAD antibody-spectrum disorders (GAD-SDs) include a group of autoimmune neurological diseases associated with neuronal excitability, most noticeably stiff person syndrome. Immune modulators are the mainstay of treatment, but a significant number of patients remain refractory. Methods: We present our single-center experience of 8 cases of GAD-SD, 2 of which were refractory to immune modulatory treatments. Results: Of the 2 cases refractory to immunomodulation, one had significant improvement with bilateral Globus Pallidus interna deep brain stimulation (GPi DBS) placement and the other with autologous hematopoietic stem cell transplant (aHSCT). Discussion: To our knowledge, this is the first instance of GPi DBS placement being noted to improve GAD-SDs movements.