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Antibodies and neuronal autoimmune disorders of the CNS

Journal of Neurology volume 257, pages 509–517 (2010)Cite this article

Abstract

We review the neuronal antibodies described in CNS disorders in order to clarify their diagnostic value, emphasize potentials pitfalls and limitations in the diagnosis of paraneoplastic neurological syndromes (PNS), and examine the current evidence for a possible pathogenic role. We propose to classify the neuronal antibodies associated with syndromes resulting from CNS neuronal dysfunction into two groups according to the location of the antigen: inside the neuron or in the cell membrane. Group I includes antibodies which target intracellular antigens and probably are not pathogenic. They are further subdivided into three groups. Group Ia comprises well-characterized onconeural antibodies (Hu (ANNA1), Yo (PCA1), Ri (ANNA2), CV2 (CRMP5), amphiphysin, Ma2) that are useful for the diagnosis of PNS. Group Ib antibodies (SOX and ZIC) are cancer-specific but there is no evidence that the immune response is in any way pathogenically related to the PNS. Antibodies in group Ic (glutamic acid decarboxylase (GAD), adenylate kinase 5 and Homer 3) identify non-PNS: stiff-person syndrome (SPS), cerebellar ataxia, and limbic encephalitis (LE). Group II antibodies recognize neuronal surface antigens. Antibodies in group IIa associate with characteristic CNS syndromes but their detection does not indicate that the disorder is paraneoplastic. Antibodies to potassium channels, AMPA and GABAB receptors are associated with LE, NMDA receptor antibodies identify a well-defined encephalitis, and antibodies against glycine receptors associate with SPS with encephalitis. A pathogenic role of the antibodies is suggested by the response of symptoms to immunotherapy and the correlation between antibody titers and neurological outcome. Lastly, Group IIb includes antibodies that are found in patients with paraneoplastic cerebellar ataxia associated with lung cancer (P/Q type calcium channels antibodies) or Hodgkin disease (metabotropic glutamate receptor type 1 antibodies).

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References

  1. Greenlee JE, Brashear HR (1983) Antibodies to cerebellar Purkinje cells in patients with paraneoplastic cerebellar degeneration and ovarian carcinoma. Ann Neurol 14:609–613

    Article  CAS  PubMed  Google Scholar 

  2. Graus F, Cordon-Cardo C, Posner JB (1985) Neuronal antinuclear antibody in sensory neuronopathy from lung cancer. Neurology 35:538–543

    CAS  PubMed  Google Scholar 

  3. Solimena M, Folli F, Denis-Donini S, Comi GC, Pozza G, De Camilli P, Vicari AM (1988) Autoantibodies to glutamic acid decarboxylase in a patient with stiff-man syndrome, epilepsy, and Type I diabetes mellitus. N Engl J Med 318:1012–1020

    CAS  PubMed  Google Scholar 

  4. Graus F, Delattre JY, Antoine JC, Dalmau J, Giometto B, Grisold W, Honnorat J, Smitt PS, Vedeler Ch, Verschuuren JJ, Vincent A, Voltz R (2004) Recommended diagnostic criteria for paraneoplastic neurological syndromes. J Neurol Neurosurg Psychiatry 75:1135–1140

    Article  CAS  PubMed  Google Scholar 

  5. Dalmau J, Rosenfeld MR (2008) Paraneoplastic syndromes of the CNS. Lancet Neurol 7:327–340

    Article  PubMed  Google Scholar 

  6. Seeger RC, Zeltzer PM, Rayner SA (1979) Onco-neural antigen: a new neural differentiation antigen expressed by neuroblastoma, oat cell carcinoma, Wilms’ tumor, and sarcoma cells. J Immunol 722:1548–1555

    Google Scholar 

  7. Graus F, Keime-Guibert F, Reñe R, Benyahia B, Ribalta T, Ascaso C, Escaramis G, Delattre JY (2001) Anti-Hu-associated paraneoplastic encephalomyelitis: analysis of 200 patients. Brain 124:1138–1148

    Article  CAS  PubMed  Google Scholar 

  8. Honnorat J, Antoine JC, Derrington E, Aguera M, Belin MF (1996) Antibodies to a subpopulation of glial cells and a 66 kDa developmental protein in patients with paraneoplastic neurological syndromes. J Neurol Neurosurg Psychiatry 61:270–278

    Article  CAS  PubMed  Google Scholar 

  9. Pittock SJ, Lucchinetti CF, Parisi JE, Benarroch EE, Mokri B, Stephan CL, Kim KK, Kilimann MW, Lennon VA (2005) Amphiphysin autoimmunity: paraneoplastic accompaniments. Ann Neurol 58:96–107

    Article  PubMed  Google Scholar 

  10. Pittock SJ, Lucchinetti CF, Lennon VA (2003) Anti-neuronal nuclear autoantibody type 2: paraneoplastic accompaniments. Ann Neurol 53:580–587

    Article  CAS  PubMed  Google Scholar 

  11. Peterson K, Rosenblum MK, Posner JB (1992) Paraneoplastic cerebellar degeneration: a clinical analysis of 55 anti-Yo antibody-positive patients. Neurology 42:1931–1937

    CAS  PubMed  Google Scholar 

  12. Dalmau J, Graus F, Villarejo A, Posner JB, Blumenthal D, Thiessen B, Saiz A, Meneses P, Rosenfeld MR (2004) Clinical analysis of anti-Ma2-associated encephalitis. Brain 127:1831–1844

    Article  PubMed  Google Scholar 

  13. Vernino S, Tuite P, Adler CH, Meschia JF, Boeve BF, Boasberg P, Parisi JE, Lennon VA (2002) Paraneoplastic chorea associated with CRMP-5 neuronal antibody and lung carcinoma. Ann Neurol 51:625–630

    Article  PubMed  Google Scholar 

  14. Monstad SE, Knudsen A, Salvesen HB, Aarseth JH, Vedeler CA (2009) Onconeural antibodies in sera from patients with various types of tumours. Cancer Immunol Immunother 58:1795–1800

    Article  CAS  PubMed  Google Scholar 

  15. Graus F, Dalmau J, Reñé R, Tora M, Malats N, Verschuuren JJ, Cardenal F, Viñolas N, Garcia del Muro J, Vadell C, Mason WP, Rosell R, Posner JB, Real FX (1997) Anti-Hu antibodies in patients with small-cell lung cancer: association with complete response to therapy and improved survival. J Clin Oncol 15:2866–2872

    CAS  PubMed  Google Scholar 

  16. Mollman JE, Hogan WM, Glover DJ, McCluskey LF (1988) Unusual presentation of cis-platinum neuropathy. Neurology 38:488–490

    CAS  PubMed  Google Scholar 

  17. Pittock SJ, Kryzer TJ, Lennon VA (2004) Paraneoplastic antibodies coexist and predict cancer, not neurological syndrome. Ann Neurol 56:715–719

    Article  CAS  PubMed  Google Scholar 

  18. Zuliani L, Saiz A, Tavolato B, Giometto B, Vincent A, Graus F (2007) Paraneoplastic limbic encephalitis associated with potassium channel antibodies: value of anti-glial nuclear antibodies in identifying the tumour. J Neurol Neurosurg Psychiatry 78:204–205

    Article  PubMed  Google Scholar 

  19. Stich O, Jarius S, Kleer B, Rasiah C, Voltz R, Rauer S (2007) Specific antibody index in cerebrospinal fluid from patients with central and peripheral paraneoplastic neurological syndromes. J Neuroimmunol 183:220–224

    Article  CAS  PubMed  Google Scholar 

  20. Graus F, Illa I, Agusti M, Ribalta T, Cruz-Sanchez F, Juarez C (1991) Effect of intraventricular injection of an anti-Purkinje cell antibody (anti-Yo) in a guinea pig model. J Neurol Sci 106:82–87

    Article  CAS  PubMed  Google Scholar 

  21. Carpentier AF, Rosenfeld MR, Delattre JY, Whalen RG, Posner JB, Dalmau J (1998) DNA vaccination with HuD inhibits growth of a neuroblastoma in mice. Clin Cancer Res 4:2819–2824

    CAS  PubMed  Google Scholar 

  22. Sommer C, Weishaupt A, Brinkhoff J, Biko L, Wessig C, Gold R, Toyka KV (2005) Paraneoplastic stiff-person syndrome: passive transfer to rats by means of IgG antibodies to amphiphysin. Lancet 365:1406–1411

    Article  CAS  PubMed  Google Scholar 

  23. Jean WC, Dalmau J, Ho A, Posner JB (1994) Analysis of the IgG subclass distribution and inflammatory infiltrates in patients with anti-Hu-associated paraneoplastic encephalomyelitis. Neurology 44:140–147

    CAS  PubMed  Google Scholar 

  24. Bernal F, Graus F, Pifarré A, Saiz A, Benyahia B, Ribalta T (2002) Immunohistochemical analysis of anti-Hu-associated paraneoplastic encephalomyelitis. Acta Neuropathol 103:509–515

    Article  CAS  PubMed  Google Scholar 

  25. Albert ML, Austin LM, Darnell RB (2000) Detection and treatment of activated T cells in the cerebrospinal fluid of patients with paraneoplastic cerebellar degeneration. Ann Neurol 47:9–17

    Article  CAS  PubMed  Google Scholar 

  26. Roberts WK, Deluca IJ, Thomas A, Fak J, Williams T, Buckley N, Dousmanis AG, Posner JB, Darnell RB (2009) Patients with lung cancer and paraneoplastic Hu syndrome harbor HuD-specific type 2 CD8+ T cells. J Clin Invest 119:2042–2051

    CAS  PubMed  Google Scholar 

  27. Bataller L, Wade DF, Graus F, Stacey HD, Rosenfeld MR, Dalmau J (2004) Antibodies to Zic4 in paraneoplastic neurologic disorders and small-cell lung cancer. Neurology 62:778–782

    CAS  PubMed  Google Scholar 

  28. Sabater L, Titulaer M, Saiz A, Verschuuren J, Güre AO, Graus F (2008) SOX1 antibodies are markers of paraneoplastic Lambert-Eaton myasthenic syndrome. Neurology 70:924–928

    Article  CAS  PubMed  Google Scholar 

  29. Güre AO, Stockert E, Scanlan MJ, Keresztes RS, Jäger D, Altorki NK, Old LJ, Chen YT (2000) Serological identification of embryonic neural proteins as highly immunogenic tumor antigens in small cell lung cancer. Proc Natl Acad Sci USA 97:4198–4203

    Article  PubMed  Google Scholar 

  30. Bataller L, Wade DF, Fuller GN, Rosenfeld MR, Dalmau J (2002) Cerebellar degeneration and autoimmunity to zinc-finger proteins of the cerebellum. Neurology 59:1985–1987

    CAS  PubMed  Google Scholar 

  31. Sabater L, Bataller L, Suárez-Calvet M, Saiz A, Dalmau J, Graus F (2008) ZIC antibodies in paraneoplastic cerebellar degeneration and small cell lung cancer. J Neuroimmunol 201–202:163–165

    Article  PubMed  CAS  Google Scholar 

  32. Graus F, Vincent A, Pozo-Rosich P, Sabater L, Saiz A, Lang B, Dalmau J (2005) Anti-glial nuclear antibody: marker of lung cancer-related paraneoplastic neurological syndromes. J Neuroimmunol 165:166–171

    Article  CAS  PubMed  Google Scholar 

  33. Wegner M, Stolt CC (2005) From stem cells to neurons and glia: a Soxist’s view of neural development. Trends Neurosci 28:583–588

    Article  CAS  PubMed  Google Scholar 

  34. Schepers GE, Teasdale RD, Koopman P (2002) Twenty pairs of Sox: extent, homology, and nomenclature of the mouse and human Sox transcriptor factor gene families. Dev Cell 3:167–170

    Article  CAS  PubMed  Google Scholar 

  35. Vural B, Chen LC, Saip P, Chen YT, Ustuner Z, Gonen M, Simpson AJ, Old LJ, Ozbek U, Gure AO (2005) Frequency of SOX Group B (SOX1, 2, 3) and ZIC2 antibodies in Turkish patients with small cell lung carcinoma and their correlation with clinical parameters. Cancer 103:2575–2583

    Article  CAS  PubMed  Google Scholar 

  36. Titulaer MJ, Klooster R, Potman M, Sabater L, Graus F, Hegeman IM, Thijssen PE, Wirtz PW, Twijnstra A, Smitt PA, van der Maarel SM, Verschuuren JJ (2009) SOX antibodies in small-cell lung cancer and Lambert-Eaton myasthenic syndrome: frequency and relation with survival. J Clin Oncol 27:4260–4267

    Article  CAS  PubMed  Google Scholar 

  37. Solimena M, Folli F, Aparisi R, Pozza G, De Camilli P (1990) Autoantibodies to GABA-ergic neurons and pancreatic beta cells in stiff-man syndrome. N Engl J Med 322:1550–1560

    Article  Google Scholar 

  38. Baekkeskov S, Aanstoot HJ, Christgau S, Reetz A, Solimena M, Cascalho M, Folli F, Richter-Olesen H, De Camilli P (1990) Identification of the 64K autoantigen in insulin-dependent diabetes as the GABA-synthesizing enzyme glutamic acid decarboxylase. Nature 347:151–156

    Article  CAS  PubMed  Google Scholar 

  39. Honnorat J, Saiz A, Giometto B, Vincent A, Brieva L, de Andrés C, Maestre J, Fabien N, Vighetto A, Casamitjana R, Thivolet C, Tavolato B, Antoine CA, Graus F (2001) Cerebellar ataxia with anti-glutamic acid decarboxylase antibodies. Arch Neurol 58:225–230

    Article  CAS  PubMed  Google Scholar 

  40. Saiz A, Blanco Y, Sabater L, Gonzalez F, Bataller L, Casamitjana R, Ramió-Torrentà L, Graus F (2008) Spectrum of neurological syndromes associated with glutamic acid decarboxylase antibodies: diagnostic clues for this association. Brain 131:2553–2563

    Article  PubMed  Google Scholar 

  41. McHugh JC, Murray B, Renganathan R, Connolly S, Lynch T (2007) GAD antibody positive paraneoplastic stiff person syndrome in a patient with renal cell carcinoma. Mov Disord 22:1343–1346

    Article  PubMed  Google Scholar 

  42. Matà S, Muscas GC, Naldi I, Rosati E, Paladini S, Cruciatti B, Bisulli F, Paganini M, Mazzi G, Sorbi S, Tinuper P (2008) Non-paraneoplastic limbic encephalitis associated with anti-glutamic acid decarboxylase antibodies. J Neuroimmunol 199:155–159

    Article  PubMed  CAS  Google Scholar 

  43. Ances BM, Vitaliani R, Taylor RA, Liebeskind DS, Voloschin A, Houghton DJ, Galetta SL, Dichter M, Alavi A, Rosenfeld MR, Dalmau J (2005) Treatment-responsive limbic encephalitis identified by neuropil antibodies: MRI and PET correlates. Brain 128:1764–1777

    Article  PubMed  Google Scholar 

  44. Lancaster E, Lai M, Peng X, Hughes E, Contastinescu R, Raizer J, Friedman D, Skeen MB, Grisold W, Kimura A, Ohta K, Iizuka T, Guzmán M, Graus F, Moss SJ, Balice-Gordon R, Dalmau J (2010) The GABAB receptor is a novel autoantigen of limbic encephalitis with prominent seizures: a case series and characterization of the antigen. Lancet Neurol 9:67–76

    Google Scholar 

  45. Tüzun E, Rossi JE, Karner SF, Centurion AF, Dalmau J (2007) Adenilate kinase 5 autoimmunity in treatment refractory limbic encephalitis. J Neuroimmunol 186:177–180

    Article  PubMed  CAS  Google Scholar 

  46. Zuliani L, Sabater L, Saiz A, Baiges JJ, Giometto B, Graus F (2007) Homer 3 autoimmunity in subacute idiopathic cerebellar ataxia. Neurology 68:239–240

    Article  CAS  PubMed  Google Scholar 

  47. Vincent A, Buckley C, Schott JM, Baker I, Dewar BK, Detert N, Clover L, Parkinson A, Bien CG, Omer S, Lang B, Rossor MN, Palace J (2004) Potassium channel antibody-associated encephalopathy: a potentially immunotherapy-responsive form of limbic encephalitis. Brain 127:701–712

    Article  PubMed  Google Scholar 

  48. Liguori R, Vincent A, Clover L, Avoni P, Plazzi G, Cortelli P, Baruzzi A, Carey T, Gambetti P, Lugaresi E, Montagna P (2001) Morvan’s syndrome: peripheral and central nervous system and cardiac involvement with antibodies to voltage-gated potassium channels. Brain 124:2417–2426

    Article  CAS  PubMed  Google Scholar 

  49. Irani SR, Buckley C, Vincent A, Cockerell OC, Rudge P, Johnson MR, Smith S (2008) Immunotherapy-responsive seizure-like episodes with potassium channel antibodies. Neurology 71:1647–1648

    Article  CAS  PubMed  Google Scholar 

  50. Iranzo A, Graus F, Clover L, Morera J, Bruna J, Vilar C, Martínez-Rodriguez JE, Vincent A, Santamaría J (2006) Rapid eye movement sleep behavior disorder and potassium channel antibody-associated limbic encephalitis. Ann Neurol 59:178–181

    Article  PubMed  Google Scholar 

  51. Jarius S, Hoffmann L, Clover L, Vincent A, Voltz R (2008) CSF findings in patients with voltage gated potassium channel antibody associated limbic encephalitis. J Neurol Sci 268:74–77

    Article  CAS  PubMed  Google Scholar 

  52. Tan KM, Lennon VA, Klein CJ, Boeve BF, Pittock SJ (2008) Clinical spectrum of voltage-gated potassium channel autoimmunity. Neurology 70:1883–1890

    Article  CAS  PubMed  Google Scholar 

  53. Vincent A (2009) Antibodies to contactin-associated protein 2 (CASPR2) in thymoma and Morvan’s syndrome. Ann Neurol 66(suppl 13): S3(abstract)

  54. Geschwind MD, Tan KM, Lennon VA, Barajas RF Jr, Haman A, Klein CJ, Josephson SA, Pittock SJ (2008) Voltage-gated potassium channel autoimmunity mimicking Creutzfeldt-Jakob disease. Arch Neurol 65:1341–1346

    Article  PubMed  Google Scholar 

  55. Alamowitch S, Graus F, Uchuya M, Reñé R, Bescansa E, Delattre JY (1997) Limbic encephalitis and small cell lung cancer. Clinical and immunological features. Brain 120:923–928

    Article  PubMed  Google Scholar 

  56. Graus F, Saiz A, Lai M, Bruna J, López F, Sabater L, Blanco Y, Rey MJ, Ribalta T, Dalmau J (2008) Neuronal surface antigen antibodies in limbic encephalitis: clinical-immunologic associations. Neurology 71:930–936

    Article  CAS  PubMed  Google Scholar 

  57. Lai M, Hughes EG, Peng X, Zhou L, Gleichman AJ, Shu H, Matà S, Kremens D, Vitaliani R, Geschwind MD, Bataller L, Kalb RG, Davis R, Graus F, Lynch DR, Balice-Gordon R, Dalmau J (2009) AMPA receptor antibodies in limbic encephalitis alter synaptic receptor location. Ann Neurol 65:424–434

    Article  CAS  PubMed  Google Scholar 

  58. Dalmau J, Tüzün E, Wu HY, Masjuan J, Rossi JE, Voloschin A, Baehring JM, Shimazaki H, Koide R, King D, Mason W, Sansing LH, Dichter MA, Rosenfeld MR, Lynch DR (2007) Paraneoplastic anti-N-methyl-d-aspartate receptor encephalitis associated with ovarian teratoma. Ann Neurol 61:25–36

    Article  CAS  PubMed  Google Scholar 

  59. Dalmau J, Gleichman AJ, Hughes EG, Rossi JE, Peng X, Lai M, Dessain SK, Rosenfeld MR, Balice-Gordon R, Lynch DR (2008) Anti-NMDA-receptor encephalitis: case series and analysis of the effects of antibodies. Lancet Neurol 7:1091–1098

    Article  CAS  PubMed  Google Scholar 

  60. Florance NR, Davis RL, Lam C, Szperka C, Zhou L, Ahmad S, Campen CJ, Moss H, Peter N, Gleichman AJ, Glaser CA, Lynch DR, Rosenfeld MR, Dalmau J (2009) Anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis in children and adolescents. Ann Neurol 66:11–18

    Article  PubMed  Google Scholar 

  61. Hughes BA, Peng X, Gleichman AJ, Lai M, Zhou L, Tsou R, Parsons TD, Lynch DR, Dalmau J, Balice-Gordon R (2009) Cellular and synaptic mechanisms underlying anti-NMDA receptor encephalitis. Ann Neurol 66(Suppl 13):S63–S64

    Google Scholar 

  62. Tüzün E, Zhou L, Baehring JM, Bannykh S, Rosendfeld MR, Dalmau J (2009) Evidence for antibody-mediated pathogenesis in anti-NMDAR encephalitis associated with ovarian teratoma. Acta Neuropathol. doi:10.1007/s00401-009-0582-4

  63. Hutchinson M, Waters P, McHugh J, Gorman G, O’Riordan S, Connolly S, Hager H, Yu P, Becker CM, Vincent A (2008) Progressive encephalomyelitis, rigidity, and myoclonus: a novel glycine receptor antibody. Neurology 71:1291–1292

    Article  CAS  PubMed  Google Scholar 

  64. Whiteley AM, Swash M, Urich H (1976) Progressive encephalomyelitis with rigidity. Brain 99:27–42

    Article  CAS  PubMed  Google Scholar 

  65. Vincent A, Leite MI, Waters P, Jacobi Ch, Becker CM, Meinck HM (2009) Glycine receptor antibodies in progressive encephalomyelitis with rigidity and myoclonus, hyperekplexia and stiff person syndrome. Ann Neurol 66(suppl 13):S50(abstract)

  66. Sillevis Smitt P, Kinoshita A, De Leeuw B, Moll W, Coesmans M, Jaarsma D, Henzen-Logmans S, Vecht C, De Zeeuw C, Sekiyama N, Nakanishi S, Shigemoto R (2000) Paraneoplastic cerebellar ataxia due to autoantibodies against a glutamate receptor. N Engl J Med 342:21–27

    Article  CAS  PubMed  Google Scholar 

  67. Coesmans M, Smitt PA, Linden DJ, Shigemoto R, Hirano T, Yamakawa Y, van Alphen AM, Luo C, van der Geest JN, Kros JM, Gaillard CA, Frens MA, de Zeeuw CI (2003) Mechanisms underlying cerebellar motor deficits due to mGluR1-autoantibodies. Ann Neurol 53:325–336

    Article  CAS  PubMed  Google Scholar 

  68. Motomura M, Lang B, Johnston I, Palace J, Vincent A, Newsom-Davis J (1997) Incidence of serum anti-P/O-type and anti-N-type calcium channel autoantibodies in the Lambert-Eaton myasthenic syndrome. J Neurol Sci 147:35–42

    Article  CAS  PubMed  Google Scholar 

  69. Graus F, Lang B, Pozo-Rosich P, Saiz A, Casamitjana R, Vincent A (2002) P/Q type calcium-channel antibodies in paraneoplastic cerebellar degeneration with lung cancer. Neurology 59:764–766

    CAS  PubMed  Google Scholar 

  70. Bürk K, Wick M, Roth G, Decker P, Voltz R (2009) Antineuronal antibodies in sporadic late-onset cerebellar ataxia. J Neurol. doi:10.1007/s00415-009-5262-8

  71. Fukuda T, Motomura M, Nakao Y, Shiraishi H, Yoshimura T, Iwanaga K, Tsujihata M, Eguchi K (2003) Reduction of P/Q-type calcium channels in the postmortem cerebellum of paraneoplastic cerebellar degeneration with Lambert-Eaton myasthenic syndrome. Ann Neurol 53:21–28

    Article  CAS  PubMed  Google Scholar 

  72. McKeon A, Fryer JP, Apiwattanakul M, Lennon VA, Hinson SR, Kryzer TJ, Lucchinetti CF, Weinshenker BG, Wingerchuk DM, Shuster EA, Pittock SJ (2009) Diagnosis of neuromyelitis spectrum disorders: comparative sensitivities and specificities of immunohistochemical and immunoprecipitation assays. Arch Neurol 66:1134–1138

    Article  PubMed  Google Scholar 

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Acknowledgments

This study was supported in part by grant PS09/00193 Fondo de Investigaciones Sanitarias, Madrid, Spain.

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  1. Servei de Neurologia, Hospital Clinic, Institut d’ Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Villarroel 170, 08036, Barcelona, Spain

    Francesc Graus & Albert Saiz

  2. Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA

    Josep Dalmau

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  1. Francesc Graus
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  2. Albert Saiz
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Correspondence to Francesc Graus.

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Graus, F., Saiz, A. & Dalmau, J. Antibodies and neuronal autoimmune disorders of the CNS. J Neurol 257, 509–517 (2010). https://doi.org/10.1007/s00415-009-5431-9

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Keywords

  • Antibodies
  • Autoimmunity
  • Paraneoplastic neurological syndromes
  • Encephalitis
  • Cerebellar degeneration
  • Epilepsy