GAD65-positive autoimmune-associated epilepsy presenting with Ictal Hand Kissing; an uncommon presentation of a rare disease
Glutamic acid decarboxylase-65 (GAD65) is an enzyme responsible for the production of gamma-aminobutyric acid (GABA). Elevated levels of GAD65 antibodies have been recognized as a key biomarker of neurological autoimmune disorders, particularly autoimmune-associated epilepsy (AAE). We report the cas...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-09-01
|
| Series: | Epilepsy & Behavior Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589986425000619 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1839639864967954432 |
|---|---|
| author | Alia M.R. Fallatah Hanan M. Abdulmutali Majed H. Alhameed |
| author_facet | Alia M.R. Fallatah Hanan M. Abdulmutali Majed H. Alhameed |
| author_sort | Alia M.R. Fallatah |
| collection | DOAJ |
| description | Glutamic acid decarboxylase-65 (GAD65) is an enzyme responsible for the production of gamma-aminobutyric acid (GABA). Elevated levels of GAD65 antibodies have been recognized as a key biomarker of neurological autoimmune disorders, particularly autoimmune-associated epilepsy (AAE). We report the case of a 48-year-old woman with drug-resistant right temporal AAE, who initially developed seizures following a febrile illness accompanied by confusion. Notably, the patient exhibited rare ictal semiology involving stereotypical Ictal Hand kissing (IHK) behavior. Brain MRI revealed bilateral mesial temporal sclerosis (MTS), which was more pronounced on the right side. High serum titers of GAD65 antibodies further supported this diagnosis. This case underscores the incompletely elucidated clinical features of GAD65-positive AAE, and highlights the unique semiology of IHK behavior and its role in understanding and characterizing possible underlying epileptogenic networks. |
| format | Article |
| id | doaj-art-0d0f41d85da1401dba1e7e2d9e90b01e |
| institution | Matheson Library |
| issn | 2589-9864 |
| language | English |
| publishDate | 2025-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Epilepsy & Behavior Reports |
| spelling | doaj-art-0d0f41d85da1401dba1e7e2d9e90b01e2025-07-04T04:46:46ZengElsevierEpilepsy & Behavior Reports2589-98642025-09-0131100801GAD65-positive autoimmune-associated epilepsy presenting with Ictal Hand Kissing; an uncommon presentation of a rare diseaseAlia M.R. Fallatah0Hanan M. Abdulmutali1Majed H. Alhameed2Corresponding author at: 5560 Tulayha Bin Khuwaylid – Al Marwah, Jeddah 23545 – 7438, Saudi Arabia.; National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi ArabiaNational Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi ArabiaNational Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi ArabiaGlutamic acid decarboxylase-65 (GAD65) is an enzyme responsible for the production of gamma-aminobutyric acid (GABA). Elevated levels of GAD65 antibodies have been recognized as a key biomarker of neurological autoimmune disorders, particularly autoimmune-associated epilepsy (AAE). We report the case of a 48-year-old woman with drug-resistant right temporal AAE, who initially developed seizures following a febrile illness accompanied by confusion. Notably, the patient exhibited rare ictal semiology involving stereotypical Ictal Hand kissing (IHK) behavior. Brain MRI revealed bilateral mesial temporal sclerosis (MTS), which was more pronounced on the right side. High serum titers of GAD65 antibodies further supported this diagnosis. This case underscores the incompletely elucidated clinical features of GAD65-positive AAE, and highlights the unique semiology of IHK behavior and its role in understanding and characterizing possible underlying epileptogenic networks.http://www.sciencedirect.com/science/article/pii/S2589986425000619GAD65Autoimmune associated epilepsyTemporal lobe epilepsyIctal kissingSeizureSemiology |
| spellingShingle | Alia M.R. Fallatah Hanan M. Abdulmutali Majed H. Alhameed GAD65-positive autoimmune-associated epilepsy presenting with Ictal Hand Kissing; an uncommon presentation of a rare disease Epilepsy & Behavior Reports GAD65 Autoimmune associated epilepsy Temporal lobe epilepsy Ictal kissing Seizure Semiology |
| title | GAD65-positive autoimmune-associated epilepsy presenting with Ictal Hand Kissing; an uncommon presentation of a rare disease |
| title_full | GAD65-positive autoimmune-associated epilepsy presenting with Ictal Hand Kissing; an uncommon presentation of a rare disease |
| title_fullStr | GAD65-positive autoimmune-associated epilepsy presenting with Ictal Hand Kissing; an uncommon presentation of a rare disease |
| title_full_unstemmed | GAD65-positive autoimmune-associated epilepsy presenting with Ictal Hand Kissing; an uncommon presentation of a rare disease |
| title_short | GAD65-positive autoimmune-associated epilepsy presenting with Ictal Hand Kissing; an uncommon presentation of a rare disease |
| title_sort | gad65 positive autoimmune associated epilepsy presenting with ictal hand kissing an uncommon presentation of a rare disease |
| topic | GAD65 Autoimmune associated epilepsy Temporal lobe epilepsy Ictal kissing Seizure Semiology |
| url | http://www.sciencedirect.com/science/article/pii/S2589986425000619 |
| work_keys_str_mv | AT aliamrfallatah gad65positiveautoimmuneassociatedepilepsypresentingwithictalhandkissinganuncommonpresentationofararedisease AT hananmabdulmutali gad65positiveautoimmuneassociatedepilepsypresentingwithictalhandkissinganuncommonpresentationofararedisease AT majedhalhameed gad65positiveautoimmuneassociatedepilepsypresentingwithictalhandkissinganuncommonpresentationofararedisease |