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Images in Neurology
May 11, 2020

Paraneoplastic Encephalomyelitis With Glutamic Acid Decarboxylase Antibodies Presenting as Longitudinal Pyramidal Tract Hyperintensity

Author Affiliations
  • 1Geriatrics and Palliative Care Department, Hospital General de L’Hospitalet de Llobregat–Consorci Sanitari Integral, L’Hospitalet de Llobregat, Barcelona, Spain
  • 2Movement Disorders Unit, Neurology Department, Hospital Sant Joan Despí Moisès Broggi–Consorci Sanitari Integral, Sant Joan Despì, Barcelona, Spain
  • 3Parkinson Unit, Centro Médico Teknon–Grupo Quiron Salud, Barcelona, Spain
  • 4Neuro-Oncology Unit, Neurology Department, Hospital Universitari de Bellvitge–Institut Català d´Oncologia–IDIBELL, L’Hospitalet de Llobregat, Barcelona, Spain
JAMA Neurol. 2020;77(7):899-900. doi:10.1001/jamaneurol.2020.0940
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    1 Comment for this article
    GAD in the Pyramidal System
    Ayman Alboudi, MD | Mercy Health Saint Mary, MSU
    The article is very interesting, with great images. However, a question would come to my mind: GAD is found in GABAergic neurons, and as far as we know pyramidal cells are not GABAergic.

    Do you have an explanation for the specific high signal on MRI brain affecting the pyramidal system? Is it possible it is a different auto-antibody? I know you checked a lot of antibodies; however, everyday there is a new auto-antibody and there are some more we don't know about.