Evidence map›Paper›PMID 40537752›Full record

ArticleBMC neurology2025

New-onset drug-resistant epilepsy in type 1 diabetes mellitus patient following COVID-19 vaccination: suspicious for autoimmune pathogenesis.

Sally Shaaban, Nirmeen A Kishk, Amani Nawito, Ahmed Hamdy, Hadeer Elsaeed AboElfarh, Mohamed Elfieshy, Mohamed Eladrousi, Michael Baghdadi, Marwa El Sayed Elktob, Ibrahim Elmenshawi

Abstract readCase Reports
In one paragraph

Article in BMC neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Sally ShaabanNeurology Department, Faculty of Medicine, Mansoura University, Dakahlia, 35511, Egypt. sallyshaaban@mans.edu.eg.ORCID http://orcid.org/0000-0001-5881-9607
Nirmeen A KishkNeurology Department, Faculty of Medicine, School of Medicine, Kasr Al-Ainy Hospital, Cairo University, Cairo, Egypt.
Amani NawitoClinical Neurophysiology Unit, Faculty of Medicine, Cairo University, Cairo, Egypt.
Ahmed HamdyNeurology Department, Faculty of Medicine, Mansoura University, Dakahlia, 35511, Egypt.
Hadeer Elsaeed AboElfarhNeurology Department, Faculty of Medicine, Mansoura University, Dakahlia, 35511, Egypt.
Mohamed ElfieshyPsychiatry Department, Faculty of Medicine, Mansoura University, Dakahlia, Egypt.
Mohamed EladrousiNeurology Department, Faculty of Medicine, Mansoura University, Dakahlia, 35511, Egypt.
Michael BaghdadiRadiology Department, Faculty of Medicine, Ministry of Health, Cairo, Egypt.
Marwa El Sayed ElktobNeurology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Ibrahim ElmenshawiNeurology Department, Faculty of Medicine, Mansoura University, Dakahlia, 35511, Egypt.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionWithin the spectrum of epilepsies, autoimmune-associated epilepsy (AAE) reflects the complexity of its presentations including refractory seizures along with cognitive decline and behavioral or psychiatric dysfunction. The suspicion of autoimmune epilepsy is heightened in individuals who have a pre-existing autoimmune condition, such as type 1 diabetes mellitus (T1DM). This report details a case of autoimmune epilepsy associated with Glutamic acid decarboxylase (GAD65) antibodies coexisting with T1DM. CASE DESCRIPTION: The subject of this clinical case is a 48-year-old male with a history of T1DM and hypothyroidism, who exhibited new behavioral alterations and refractory focal seizures two weeks post- COVID-19 vaccination. Initially, his symptoms were misinterpreted as panic attacks. Months later, these attacks were diagnosed as focal epilepsy after multiple evaluations including, interictal and ictal electroencephalograms, brain Magnetic Resonance Imaging (MRI), and Positron Emission Tomography (PET). The patient underwent several trials of antiseizure medications and their combinations, yet no significant effects were observed. The Antibody Prevalence in Epilepsy and Encephalopathy (APE2) score was determined, yielding a result of 4, and the presence of elevated Glutamic acid decarboxylase (GAD65) antibodies in the serum led to a confirmed diagnosis of autoimmune encephalitis (AAE). Following a course of intravenous immunoglobulin, no notable improvement was recorded; however, subsequent corticosteroid therapy, accompanied by rigorous blood glucose monitoring, resulted in a positive but partial reduction in seizure frequency. The patient was planned to start on long-term use of azathioprine.

conclusionThis case exemplifies the diagnostic challenges inherent in autoimmune-associated epilepsy and underscores the necessity for prompt intervention. Glutamic acid decarboxylase (GAD65) antibody-associated autoimmune epilepsy should be suspected in adult-onset temporal lobe epilepsy with co-morbid type 1 DM with early initiation of immune therapy for better clinical outcomes.

Indexed as

COVID-19 VaccinesDiabetes Mellitus, Type 1Drug Resistant EpilepsyAutoantibodiesCOVID-19Glutamate DecarboxylaseHumansMaleMiddle AgedAutoantibodiesCOVID-19 VaccinesGlutamate Decarboxylaseglutamate decarboxylase 2Autoimmune-associated epilepsyGlutamic acid decarboxylase 65Temporal lobe epilepsyType 1 diabetes mellitus

Identifiers

PMID40537752
PMCPMC12180254

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.