{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T11:04:27Z","timestamp":1789729467911,"version":"4.0.1"},"reference-count":10,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Annals of Neurology"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:p>Gephyrin is a postsynaptic scaffold protein essential for inhibitory neurotransmission. Gephyrin\u2010immunoglobulin G (IgG) was reported, decades ago, in a single case of paraneoplastic stiff\u2010person\u2010like syndrome, but its broader clinical relevance remains unknown. While investigating unclassified synaptic IgGs mimicking amphiphysin\u2010IgG, we identified gephyrin\u2010IgG in 3 patients using human protein microarray. Gephyrin specificity was confirmed using confocal tissue\u2010based immunofluorescence assay, cell\u2010based assay, and Western blot. The 3 patients, all female, had: encephalitis (2) and myeloneuropathy and breast cancer (1). All had inflammatory cerebrospinal fluid and abnormal magnetic resonance imaging, and improved following immunotherapy. Gephyrin\u2010IgG is associated with a treatable autoimmune neurological disease, sometimes paraneoplastic. 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