Clinical features of leucine-rich glioma-inactivated 1 antibody-positive autoimmune encephalitis / 中风与神经疾病杂志

ABSTRACT

@#Objective To investigate the clinical manifestations, imaging features, treatment, and prognosis of autoimmune encephalitis （AE） with positive leucine-rich glioma-inactivated 1 （LGI1） antibody. Methods A retrospective analysis was performed for the clinical data of 11 patients with LGI1 antibody-positive AE who were admitted to Department of Neurology, The Sixth Medical Center of PLA General Hospital, from 2018 to 2022. Results Among these 11 patients, there were 10 patients with epilepsy, 8 patients with cognitive impairment, 6 patients with mental and behavioral disorders, 5 patients with sleep disorders, 1 patient with speech and language impairment, 1 patient with involuntary limb movements, 1 patient with dizziness, and 7 patients with hyponatremia. All 11 patients tested positive for LGI1 antibody, and 8 patients tested positive in serum and cerebrospinal fluid; 1 patient was also positive for contactin-associated protein-like 2 antibody, and 3 patients were positive for a single antibody in serum. Lung CT showed that 1 patient had space-occupying lesion, cranial magnetic resonance imaging showed abnormalities in 6 patients, and positron emission tomography/computed tomography showed abnormalities in 3 patients. There were 7 patients with electroencephalographic abnormalities. All 11 patients had improvements in symptoms after immunotherapy. Five patients were followed up, and 6 were lost to follow-up. Conclusion The main manifestations of LGI antibody encephalitis include seizure, faciobrachial dystonic seizures, cognitive impairment, and mental and behavioral disorders accompanied by hyponatremia. The titer of LGI1 antibody in serum is more sensitive than that in cerebrospinal fluid, and a few patients may have multiple positive autoantibodies. Immunotherapy is an effective treatment method for LGI1 antibody-positive AE.