E-Pearl of the Week: LGI1 Antibodies in Limbic Encephalitis
May 29, 2013
Limbic encephalitis is attributed to antibody-mediated processes in an increasing number of cases. Since 2010, antibodies to accessory proteins of the voltage-gated potassium channel complex have been described, namely leucine-rich glioma-inactivated (LGI1) and contactin-associated protein 2 (CASPR2). LGI1 antibody associated limbic encephalitis is characterized by clinical seizures in 82% of patients, and video-EEG monitoring suggests tonic seizures may be the most common seizure-type. Additionally, hyponatremia occurs in 60% of patients, thought secondary to LGI1 expression in the hypothalamus and kidney. With immunotherapy, more than three quarters will achieve significant recovery.
- Lai M, Huijbers MG, Lancaster E, et al. Investigation of LGI1 as the antigen in limbic encephalitis previously attributed to potassium channels: a case series. Lancet Neurology 2010; 9: 776-785.
- Andrade DM, Tai P, Dalmau J, Wennberg R. Tonic seizures: A diagnostic clue of anti-LGI1 encephalitis? Neurology 2011;76:1355-1357.
Submitted by Adam Numis MD, Resident Physician, University of California, San Francisc
Disclosure: Dr. Numis serves on the editorial team for the Neurology Resident and Fellow Section.