Clinical Practice and Cases in Emergency Medicine (Aug 2021)

Altered Mental Status in the Emergency Department – When to Consider Anti-LGI-1 Encephalitis: Case Report

  • Stephanie S. Miljkovic,
  • B. Witkind Koenig

DOI
https://doi.org/10.5811/cpcem.2021.4.51535
Journal volume & issue
Vol. 5, no. 3

Abstract

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Introduction: Anti-leucine-rich glioma inactivated-1 (LGI-1) is one of few antibodies implicated in limbic encephalitis, a syndrome that can result in permanent neurological symptoms if left untreated. Case Report: We present a patient with dystonic seizures, progressive cognitive decline, psychiatric symptoms and short-term memory loss, and mild hyponatremia diagnosed with anti-LGI-1 antibody limbic encephalitis. Conclusion: There are few reports in the emergency medicine community describing anti-LGI-1 antibody limbic encephalitis. Delay in diagnosis can risk irreversible limbic damage. Therefore, it is important for the emergency physician to be aware of anti-LGI-1 antibody limbic encephalitis when presented with adult-onset seizures and altered mental status of unknown etiology.