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Neurological Rehabilitation

A Case Report of Functional Recovery in GAD-positive Autoimmune Encephalitis: The Role of Multidisciplinary Rehabilitation and Orthotic Management

Saturday, October 25, 2025
12:00 PM - 1:30 PM MT
Location: Kiosk 5

    Poster Presenter(s)

  • Caroline Jones, Other

    Medical Student
    University of Miami Leonard M Miller School of Medicine Department of PM&R
    Miami, Florida

    • Co-Author(s)

  • Lance Reccoppa, MD

    Resident Physician
    University of Miami/Jackson Health System PM&R Program
    Miami, Florida

  • ZH

    Zeeshan Haque, MD

    Brain Injury Medicine Fellow (PGY-5)
    University of Miami/Jackson Health System PM&R Program
    Miami, Florida

  • GA

    Gemayaret Alvarez, MD

    Associate Professor
    University of Miami Health System
    Miami, Florida

Disclosure(s):
Caroline Jones, Other: No financial relationships to disclose
Zeeshan Haque, MD: No financial relationships to disclose
Case Diagnosis: A 31 year-old male with GAD+ Autoimmune Encephalitis underwent acute inpatient rehabilitation.

Case Description or Program Description: A 31-year-old male with GAD-positive autoimmune encephalitis presented with refractory seizures and was treated with six antiepileptic medications and IVIG. He transferred to acute inpatient rehabilitation after four days of treatment. During his two-week stay, he demonstrated significant functional improvements through physical therapy (PT), occupational therapy (OT), and speech-language pathology (SLP). Initially requiring moderate assistance for transfers and ambulation, he progressed to independent bed mobility and modified independent transfers with a rolling walker. His ambulation distance increased from 150 feet with moderate assistance to 250 feet with supervision, while his Berg Balance Scale score improved from 18 to 31. Despite moderate to severe cognitive-linguistic deficits, he advanced to requiring supervision for comprehension and expression. The hospital course was complicated by persistent left lower extremity pain, attributed to poorly fitted ankle-foot orthotics (AFOs) for bilateral foot drop. After receiving new AFOs, the patient reported improved pain levels.

Setting: Acute Inpatient Rehabilitation

Assessment/Results: The patient made significant functional gains during rehabilitation, achieving greater independence in ambulation, balance, and mobility. While persistent pain posed challenges, it improved with well-fitted orthotics.

Discussion (relevance): To our knowledge, this is the first case report describing the rehabilitation course of a patient with GAD encephalitis. This case highlights the importance of structured therapy and a multidisciplinary approach to optimize outcomes for patients like these.

Conclusions: A multidisciplinary rehabilitation approach, incorporating physical therapy, occupational therapy, speech-language pathology, and orthotic management, can be crucial for enhancing mobility, balance, and overall quality of life for patients like this with GAD autoimmune encephalitis.