Clinical characteristics of anti ⁃ leucine ⁃ rich glioma ⁃ inactivated 1 antibody associated encephalitis

Abstract

Objective To summarize the clinical features of anti⁃leucine⁃rich⁃glioma⁃inactivation 1 (LGI1) antibody associated encephalitis. Methods and Results A total of 13 patients with anti ⁃ LGI1 antibody associated encephalitis were admitted to Huai'an No. 3 People's Hospital from March 2018 to October 2022. The first symptoms were focal seizure in 6 cases, psychiatric symptom in 3 cases, recent memory loss in 2 cases and faciobrachial dystonic seizures (FBDS) in 2 cases. Serum anti⁃LGI1 antibody was positive in 10 cases, cerebrospinal fluid (CSF) anti⁃LGI1 antibody was positive in 2 cases. And 4 cases had hyponatremia. MRI showed abnormal findings in 9 cases, including 3 cases of hippocampal FLAIR hyperintensity, 4 cases of lacunar infarction, one case of cortical and subcortical mild cerebral atrophy, and one case of subcortical white matter ischemic changes. EEG abnormalities were observed in 10 cases, including focal epileptoid discharge in 5 cases and slow wave increase in 5 cases. Twelve cases received immunotherapy and 6 cases received antiepileptic seizure medicine. The prognosis was good in 10 cases and poor in 3 cases. Conclusions The main clinical manifestations of anti ⁃ LGI1 antibody associated encephalitis include seizures, mental disorders and recent memory loss, FBDS as its characteristic manifestations, may be accompanied by hyponatremia, immunotherapy should be started as soon as possible.

Keywords

• encephalitis
• autoimmune diseases of the nervous system
• dystonic disorders
• hyponateramia
• immunotherapy