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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Alzheimer's Ruled Out. Tests Showed High GAD65 Antibodies, Lighted Area In Brain, Slow Brain Waves. Diagnosed To Be Dementia. Right?

My husband began having a fast developing dementia in October, and it has gotten very bad. I would characterize his symptoms as later stage of Alzheimer s Disease. He is nearly always incohert, his cognitive abilities are practically gone, and he thinks he isn t in his own home. He knows everyone--friends and family. He has no pain, no seizures. His takes very small steps, like an old man. He s had CT scans, MRI, 2 spinal taps, Pet scan , EEG . His neurologist has rule out Alzheimer s. The MRI had a lighted area in his brain, but no cancers cells in LP. EEG showed slow brain waves, but nothing definitive. PET scan did not suggest Alzheimer s. Last spinal tap showed a high level of GAD65 antibodies (.2 titer). Five years ago, he was diagnosed with Stage IV NSCLC . He s had chemo, the last type being Tarceva, which he no longer takes. His diagnosis presently is dementia. What are the doctors missing, if anything?
Sat, 9 Feb 2013
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Neurologist 's  Response
Thanks for posting this question in HCM
Let me tell you that demetia has so many causes.
If the symtoms have been noticed for the last few months only and he is rapidly progressing, a pssibility of rapidly progessing dementia will be likely. Other conditions that can behave in this way are autoimmune encephalitis (more so when the GAD 65 IS ELEVATED), vitamin B12 deficinecy, thyroid problem, Hashimotos' encephalopathy. In the background hisotory of cancer, i will advise you to discuss the MRI and all the scans with a neuroradiologist.
Please note that another rare cause of this type of illness is cruzfeldt jacob's disease
He needs to br re-evaluated by a neurologist or cognitive expert who will synthesize all the reports and guide you. If found to have auto-immune encephalitis, he may recover with immunomodulator.

Hope this clarifies
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Alzheimer's Ruled Out. Tests Showed High GAD65 Antibodies, Lighted Area In Brain, Slow Brain Waves. Diagnosed To Be Dementia. Right?

Thanks for posting this question in HCM Let me tell you that demetia has so many causes. If the symtoms have been noticed for the last few months only and he is rapidly progressing, a pssibility of rapidly progessing dementia will be likely. Other conditions that can behave in this way are autoimmune encephalitis (more so when the GAD 65 IS ELEVATED), vitamin B12 deficinecy, thyroid problem, Hashimotos encephalopathy. In the background hisotory of cancer, i will advise you to discuss the MRI and all the scans with a neuroradiologist. Please note that another rare cause of this type of illness is cruzfeldt jacob s disease He needs to br re-evaluated by a neurologist or cognitive expert who will synthesize all the reports and guide you. If found to have auto-immune encephalitis, he may recover with immunomodulator. Hope this clarifies