The Treatment and Follow-Up of Anti-LGI1 Limbic Encephalitis.

OBJECTIVE

This study aims to retrospectively study clinical characteristics, diagnosis, treatment and follow-up visits in patients with anti-leucine-rich glioma inactivated-1 (LGI1) limbic encephalitis (LE) for prompting the early diagnosis and efficacious treatment of this disease.

METHODS

Four anti-LGI1 LE patients were hospitalized in the Department of Neurology at the First Hospital of Jilin University. Data from their clinical manifestations, diagnoses, treatments and follow-up visits were analyzed.

RESULTS

Four patients with anti-LGI1 LE were characterized by hypomnesia, mental and behavior disorder, faciobrachial dystonic seizures (FBDS), seizures accompanied by pathological changes in the limbic system, obstinate hyponatremia and positive detection of anti-LGI1 antibody. In this study, we found that 1 patient initially presented with an abnormal sensation and had a subsequent FBDS, inconsistent with normal cases of anti-LGI1 LE. This patient had abnormalities in the basal ganglia region identified with head MRI, unlike most cases, which report abnormalities in the limbic system by positron emission tomography/CT scan. Finally, 3 of our patients with FBDS were treated with antiepileptic drugs as well as immune modulatory treatment, and they responded well.

CONCLUSIONS

We identified new characteristics in clinical manifestation, diagnosis and treatment of anti-LGI1 LE, which contribute to a better understanding of this disease and help improve its early diagnosis and efficacious treatment.