PT  - JOURNAL ARTICLE
AU  - Kiran Samra
AU  - Jonathan Rogers
AU  - Mohamed Mahdi-Rogers
AU  - Biba Stanton
TI  - Catatonia with GABA<sub>A</sub> receptor antibodies
AID  - 10.1136/practneurol-2019-002388
DP  - 2020 Apr 01
TA  - Practical Neurology
PG  - 139--143
VI  - 20
IP  - 2
4099  - http://pn.bmj.com/content/20/2/139.short
4100  - http://pn.bmj.com/content/20/2/139.full
SO  - Pract Neurol2020 Apr 01; 20
AB  - A 22-year-old African woman developed acute behavioural change, against a background of sickle cell disease with strokes requiring a ventriculoperitoneal shunt. She alternated between mutism with prolonged staring and posturing, and a state of agitation with elation and echolalia. Cerebrospinal fluid (CSF) protein was elevated and electroencephalogram showed mild slowing with bitemporal slow and sharp waves. We suspected catatonia secondary to possible autoimmune encephalitis but her condition persisted despite intravenous methylprednisolone. After identifying a positive serum anti-gamma-aminobutyric acid-A (GABAA) antibody, treatment with intravenous immunoglobulin, oral corticosteroids and rituximab led to gradual improvement. Patients with catatonia may show reduced GABAA receptor density and there are two other reports of catatonia with anti-GABAA antibodies. This patient’s treatment response supports the antibody’s causative role.