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Autoimmune Ataxias

  • Marios HadjivassiliouEmail author
  • Hiroshi Mitoma
  • Mario Manto
Chapter
Part of the Contemporary Clinical Neuroscience book series (CCNE)

Abstract

The dramatic progress to genetically characterise the ataxias, using next-generation sequencing (NGS), has also facilitated our appreciation that a substantial number of sporadic ataxias are not due to genetic defects but likely to be immune-mediated. At the same time, the recent identification of an increasing number of antibodies linked to sporadic ataxias has aided the diagnostic pathway for immune-mediated cerebellar ataxias (IMCAs). However, the diagnosis of IMCA remains problematic if it is solely dependent on the serological screening for such antibodies and also because there is significant phenotypic overlap with non-immune forms of ataxia. In the majority of cases, serological screening for known antibodies associated with IMCA may not be readily available. In others no specific antigenic trigger or associated antibodies have been identified as yet. Therefore, recognition of IMCA relies on clinical expertise, indirect evidence of autoimmunity (additional autoimmune diseases or family history of autoimmune disease) and appropriate investigations. It is imperative to consolidate quickly such a diagnosis as therapeutic interventions can be effective in preserving the cerebellar reserve.

Keywords

Immune-mediated cerebellar ataxias (IMCAs) Gluten ataxia Anti-GAD ataxia Paraneoplastic cerebellar degeneration Opsoclonus-myoclonus ataxia syndrome Anti-DPPX ataxia Anti-MAG ataxia CLIPPERS syndrome Sjogren’s ataxia Lupus ataxia 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Marios Hadjivassiliou
    • 1
    Email author
  • Hiroshi Mitoma
    • 2
  • Mario Manto
    • 3
    • 4
  1. 1.Academic Department of Neurosciences, Royal Hallamshire HospitalSheffieldUK
  2. 2.Medical Education Promotion CenterTokyo Medical UniversityTokyoJapan
  3. 3.Department of Neurology, CHU-CharleroiCharleroiBelgium
  4. 4.Department of NeurosciencesUniversity of MonsMonsBelgium

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