Pseudo pre-excitation ECG changes in a patient with anti-GAD mediated autoimmune limbic encephalitis

Andrew S. Moriarty; Thomas Kelly; Kirstie N. Anderson; Stephen Lord

doi:10.1016/j.npbr.2013.01.001

Pseudo pre-excitation ECG changes in a patient with anti-GAD mediated autoimmune limbic encephalitis

Andrew S. Moriarty^*, Thomas Kelly, Kirstie N. Anderson, Stephen Lord

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

Abstract

We report the case of a 30-year-old male patient presenting with complex partial seizures and amnesia and diagnosed with anti-glutamic acid decarboxylase (anti-GAD) mediated autoimmune limbic encephalitis. New onset ECG changes consistent with pre-excitation were co-existent and resolved entirely with immunotherapy. This association has not been previously reported in the literature. Pre-excitation is usually attributable to an accessory cardiac pathway, the presence of which was excluded in the case. Instead, we posit a potential deleterious, reversible effect of anti-GAD antibodies on cardiac membrane stability. Given the risk of sudden cardiac death associated with such ECG profiles, we highlight the need for neurologists to be aware of this potential association and of the possible benefits of specialist cardiological involvement. Further work should be undertaken to elucidate the nature of this association, and clinicians should be mindful of the potentially adverse consequences thereof.

Original language	English
Pages (from-to)	53-55
Number of pages	3
Journal	Neurology Psychiatry and Brain Research
Volume	19
Issue number	1
DOIs	https://doi.org/10.1016/j.npbr.2013.01.001
Publication status	Published - 1 Feb 2013

Keywords

Autoimmune
Channelopathy
Conduction abnormalities
Pseudo pre-excitation

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title = "Pseudo pre-excitation ECG changes in a patient with anti-GAD mediated autoimmune limbic encephalitis",

abstract = "We report the case of a 30-year-old male patient presenting with complex partial seizures and amnesia and diagnosed with anti-glutamic acid decarboxylase (anti-GAD) mediated autoimmune limbic encephalitis. New onset ECG changes consistent with pre-excitation were co-existent and resolved entirely with immunotherapy. This association has not been previously reported in the literature. Pre-excitation is usually attributable to an accessory cardiac pathway, the presence of which was excluded in the case. Instead, we posit a potential deleterious, reversible effect of anti-GAD antibodies on cardiac membrane stability. Given the risk of sudden cardiac death associated with such ECG profiles, we highlight the need for neurologists to be aware of this potential association and of the possible benefits of specialist cardiological involvement. Further work should be undertaken to elucidate the nature of this association, and clinicians should be mindful of the potentially adverse consequences thereof.",

keywords = "Autoimmune, Channelopathy, Conduction abnormalities, Pseudo pre-excitation",

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AU - Moriarty, Andrew S.

AU - Kelly, Thomas

AU - Anderson, Kirstie N.

AU - Lord, Stephen

PY - 2013/2/1

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N2 - We report the case of a 30-year-old male patient presenting with complex partial seizures and amnesia and diagnosed with anti-glutamic acid decarboxylase (anti-GAD) mediated autoimmune limbic encephalitis. New onset ECG changes consistent with pre-excitation were co-existent and resolved entirely with immunotherapy. This association has not been previously reported in the literature. Pre-excitation is usually attributable to an accessory cardiac pathway, the presence of which was excluded in the case. Instead, we posit a potential deleterious, reversible effect of anti-GAD antibodies on cardiac membrane stability. Given the risk of sudden cardiac death associated with such ECG profiles, we highlight the need for neurologists to be aware of this potential association and of the possible benefits of specialist cardiological involvement. Further work should be undertaken to elucidate the nature of this association, and clinicians should be mindful of the potentially adverse consequences thereof.

AB - We report the case of a 30-year-old male patient presenting with complex partial seizures and amnesia and diagnosed with anti-glutamic acid decarboxylase (anti-GAD) mediated autoimmune limbic encephalitis. New onset ECG changes consistent with pre-excitation were co-existent and resolved entirely with immunotherapy. This association has not been previously reported in the literature. Pre-excitation is usually attributable to an accessory cardiac pathway, the presence of which was excluded in the case. Instead, we posit a potential deleterious, reversible effect of anti-GAD antibodies on cardiac membrane stability. Given the risk of sudden cardiac death associated with such ECG profiles, we highlight the need for neurologists to be aware of this potential association and of the possible benefits of specialist cardiological involvement. Further work should be undertaken to elucidate the nature of this association, and clinicians should be mindful of the potentially adverse consequences thereof.

KW - Autoimmune

KW - Channelopathy

KW - Conduction abnormalities

KW - Pseudo pre-excitation

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Pseudo pre-excitation ECG changes in a patient with anti-GAD mediated autoimmune limbic encephalitis

Abstract

Keywords

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