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Rare disease
CASE REPORT
Anti-LGI1 encephalitis causing faciobrachial dystonic seizures
  1. Stamatios Zouras1,
  2. Jeffrey W Stephens2,
  3. Srinivasa Rao Abburu3,
  4. Chika Emelle4
  1. 1Endocrinology and Diabetes Department, Morriston Hospital, Swansea, UK
  2. 2College of Medicine, Swansea University, Swansea, UK
  3. 3Radiology Department, Morriston Hospital, Swansea, UK
  4. 4Department of Medicine, ABM University Health Board, Swansea, UK
  1. Correspondence to Dr Stamatios Zouras, szouras{at}yahoo.gr

Summary

Anti-leucine-richglioma inactivated protein 1 (LGI1) encephalitis has an autoimmune origin and can be reversed with immunotherapy. It is obvious that identifying and treating this condition early is of paramount importance. We present the case of a 69-year-old man who was admitted to hospital with faciobrachial dystonic seizures and was found to have antibodies to LGI1. His symptoms started approximately 3 months prior admission to the hospital. There had also been some subtle cognitive impairment. He was treated with two courses of intravenous immunoglobulin and commenced on prednisolone 50 mg daily and clonazepam 500 µg at night. Despite these treatments, his seizures were becoming progressively more frequent and severe. He then underwent treatment with a course of plasma exchange followed by an intravenous infusion of methylprednisolone and returned to his previous baseline function.

  • neurology
  • neuroimaging

https://doi.org/10.1136/bcr-2017-221089

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    Footnotes

    • Contributors SZ treated the patient, presented the case at a grand round, interpreted data, wrote manuscript and acted as corresponding author. JS made contribution to drafting the article and critically revised it. SRA reviewed all the CT and MRI scan images and helped with the differential diagnosis of the case. CE helped to collect the data for the manuscript.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.