GAD1 and neoplasm: Glutamic acid decarboxylase 65 (GAD65) antibody (Ab)-associated autoimmune encephalitis (AE) usually presents with symptoms of limbic encephalitis (LE) including temporal lobe epilepsy, cognitive deficit, and psychiatric disturbance.[1] It is regarded as typically not related to an underlying tumor, although the risk of cancer increases with age, male sex, and the coexistence of neuronal cell-surface antibodies.[2] GAD Ab-related extralimbic encephalitis (ELE) without limbic symptoms is very rare and has only been reported in 2 cases,[3,4] both presented with isolated epilepsy.