Category: Other
Objective: This study aims to evaluate the clinical spectrum of antibody-associated movement disorders from a single centre.
Background: There is an increasing recognition of movement disorders (MD) associated with anti-neuronal antibodies, which are potentially treatable.
Method: Retrospective review of the clinical records of patients diagnosed with autoimmune encephalitis (AIE) or with a positive result for an anti-neuronal antibody in the period between 2007 and 2023.
Results: Twenty-four patients were diagnosed with MD, 14 (58.3%) male, with a median age at presentation of 47.0 (11.3-60.0) years. In 8 (33.3%) the MD was the presenting symptom and in 7 (29.2%) it occurred in isolation. Sixteen (66.7%) patients had AIE. Sixteen (66.7%) patients had an hyperkinetic disorder, 3 (12.5%) hypokinetic, 4 (16.7%) a Stiff-Person-Spectrum Disorder (SPSD), and 1 (4.6%) ataxia. Four (16.7%) had an acute onset, 14 (58.3%) subacute and 6 (25.0%) chronic. Pediatric cases (n=9) presented with dystonia (2; 22.2%), coreo-dystonia (1;11.1%), dystonia combined with catatonia and myoclonus (1; 11.1% each), acatysia, tics, stereotypies and progressive encephalomyelitis with rigidity and myoclonus (PERM) (1;11.1% each). Adult patients (n=15) presented with SPSD (3; 20.0%), parkinsonism (3; 20.0%), dystonia (2; 13.3%), postural tremor (2; 13.3%), myoclonus and ataxia (2; 13.3%), ataxia (1; 6.7%), dystonia and ataxia (1; 6.7%), and myoclonus (1; 6.7%). Different phenomenologies were associated with the following antibodies: Dystonia – anti-NMDAr and anti-GAD65; ataxia – anti-GAD65, anti-Ri, anti-Ma2 and anti-CV; myoclonus – anti-NMDAr, anti-Ri, anti-glycin and anti-Ma2; SPSD – anti-GAD65; PERM – anti-glycin. Eighteen (75.0%) patients improved after immunotherapy. Two patients had tumours of the breast (anti-Ri) and lung (anti-Ma2).
Conclusion: Anti-neuronal antibodies can be associated with a wide range of MD phenomenologies. Pediatric patients more commonly present with hyperkinetic disorders. Most cases are responsive to immunotherapy.
To cite this abstract in AMA style:
J. Moura, S. Costa, I. Carrilho, S. Figueiroa, P. Carneiro, E. Neves, J. Damásio, E. Santos, R. Samões. Antibody-mediated movement disorders: a single-centre retrospective study [abstract]. Mov Disord. 2024; 39 (suppl 1). https://www.mdsabstracts.org/abstract/antibody-mediated-movement-disorders-a-single-centre-retrospective-study/. Accessed December 3, 2024.« Back to 2024 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/antibody-mediated-movement-disorders-a-single-centre-retrospective-study/