Alternating Skew Deviation in Association with Anti-Glutamic Acid Decarboxylase Antibodies

ABSTRACT

The presence of an elevated anti-glutamic acid decarboxylase (GAD) antibody level has been associated with a number of eye movement abnormalities as well as other findings, including cerebellar ataxia and insulin-dependent diabetes mellitus. Skew deviation in association with anti-GAD antibodies has not been previously reported. Here the authors report a case of alternating skew deviation along with cerebellar-brainstem signs in a patient with an elevated anti-GAD antibody titre. Follow-up neurologic evaluation after treatment with intravenous immunoglobulin revealed improvement in cerebellar-brainstem signs, whereas ophthalmic evaluation was stable.

• Anti-GAD
• cerebellar findings
• skew deviation

Acknowledgment

This work was supported by the National Institutes of Health (K12EY021475 and K23 EY 024345 (H.M.) and an unrestricted grant to the Department of Ophthalmology and Visual Sciences at the University of Illinois from Research to Prevent Blindness Inc. (A.F., K.S., H.M.).

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.