Clinical diagnosis of LGI1 antibody encephalitis in an 83-year-old woman

An 83-year-old woman was referred to hospital with a 2-week history of short-lived episodic unpleasant sensations in her head and running down her body. This was accompanied by new short-term memory impairment and arm spasms. Initial investigations including blood tests and brain imaging did not rev...

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Main Authors: Attwood, JE, Naseer, S, Michael, S, Riley, J
Format: Journal article
Language:English
Published: BMJ Publishing Group 2021
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author Attwood, JE
Naseer, S
Michael, S
Riley, J
author_facet Attwood, JE
Naseer, S
Michael, S
Riley, J
author_sort Attwood, JE
collection OXFORD
description An 83-year-old woman was referred to hospital with a 2-week history of short-lived episodic unpleasant sensations in her head and running down her body. This was accompanied by new short-term memory impairment and arm spasms. Initial investigations including blood tests and brain imaging did not reveal the diagnosis. The patient developed an increasing frequency of abnormal movements of her face and arm. These were clinically recognised as faciobrachial dystonic seizures (FBDS). FBDS are pathognomonic of an autoimmune encephalitis caused by an antibody directed against leucine-rich glioma-inactivated 1 (LGI1). The clinical diagnosis resulted in treatment with immunotherapy, leading to cessation of seizures and rapid cognitive recovery. Later, the predicted serology was confirmed. This reversible and under-recognised cause of cognitive impairment, typically affecting elderly patients, can be diagnosed clinically to enable early and effective treatment.
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spelling oxford-uuid:03e74b03-ae34-4c61-ae55-0c995685d0652024-01-09T11:47:27ZClinical diagnosis of LGI1 antibody encephalitis in an 83-year-old womanJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:03e74b03-ae34-4c61-ae55-0c995685d065EnglishSymplectic ElementsBMJ Publishing Group2021Attwood, JENaseer, SMichael, SRiley, JAn 83-year-old woman was referred to hospital with a 2-week history of short-lived episodic unpleasant sensations in her head and running down her body. This was accompanied by new short-term memory impairment and arm spasms. Initial investigations including blood tests and brain imaging did not reveal the diagnosis. The patient developed an increasing frequency of abnormal movements of her face and arm. These were clinically recognised as faciobrachial dystonic seizures (FBDS). FBDS are pathognomonic of an autoimmune encephalitis caused by an antibody directed against leucine-rich glioma-inactivated 1 (LGI1). The clinical diagnosis resulted in treatment with immunotherapy, leading to cessation of seizures and rapid cognitive recovery. Later, the predicted serology was confirmed. This reversible and under-recognised cause of cognitive impairment, typically affecting elderly patients, can be diagnosed clinically to enable early and effective treatment.
spellingShingle Attwood, JE
Naseer, S
Michael, S
Riley, J
Clinical diagnosis of LGI1 antibody encephalitis in an 83-year-old woman
title Clinical diagnosis of LGI1 antibody encephalitis in an 83-year-old woman
title_full Clinical diagnosis of LGI1 antibody encephalitis in an 83-year-old woman
title_fullStr Clinical diagnosis of LGI1 antibody encephalitis in an 83-year-old woman
title_full_unstemmed Clinical diagnosis of LGI1 antibody encephalitis in an 83-year-old woman
title_short Clinical diagnosis of LGI1 antibody encephalitis in an 83-year-old woman
title_sort clinical diagnosis of lgi1 antibody encephalitis in an 83 year old woman
work_keys_str_mv AT attwoodje clinicaldiagnosisoflgi1antibodyencephalitisinan83yearoldwoman
AT naseers clinicaldiagnosisoflgi1antibodyencephalitisinan83yearoldwoman
AT michaels clinicaldiagnosisoflgi1antibodyencephalitisinan83yearoldwoman
AT rileyj clinicaldiagnosisoflgi1antibodyencephalitisinan83yearoldwoman