Downbeating Nytagmu and Mucle pam in a Patient with Glutamic-acid Decarboxylae Antibodie

Purpoe To report the ophthalmic finding and repone to treatment in a patient with glutamic-acid decarboxylae antibodie. Deign Cae report. Method A 55-year-old woman developed progreive, painful, low back mucle pam, vertical diplopia, downbeating nytagmu, and aymmetric appendicular ataxia. Reult Downbeating nytagmu wa preent in primary gaze with an alternating kew deviation in lateral gaze. erum and cerebropinal fluid GAD antibodie were detected. Treatment with diazepam led to reolution of paticity, wherea repeated coure of intravenou immunoglobulin improved cerebellar function, including appendicular ataxia and downbeating nytagmu. Concluion Patient with GAD antibodie may have element of both tiff-peron yndrome (mucle rigidity and pam) and prominent cerebellar dyfunction. Treatment with diazepam rapidly improved tiff-peron ymptom, wherea IVIg wa partially effective at the early tage of cerebellar dyfunction.