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Area of Science:

  • Neurology
  • Immunology
  • Cardiology

Background:

  • Anti-LGI1 encephalitis is an autoimmune limbic encephalitis.
  • This case report details clinical features, outcomes, and pathophysiology of sinus arrest in anti-LGI1 encephalitis.

Observation:

  • A 49-year-old female presented with acute confusional state and focal seizures.
  • She experienced sinus arrest requiring temporary pacemaker implantation.
  • Laboratory tests revealed hyponatremia and LGI1-IgG antibodies.

Findings:

  • Repetitive focal dystonic seizures, confusion, amnestic deficits, sinus arrest, and hyponatremia are characteristic of anti-LGI1 encephalitis.
  • Sinus arrest may result from direct autonomic dysfunction or ictal/postictal events.
  • Neurocognitive function normalized within a month after treatment.

Implications:

  • Early diagnosis and prompt immunosuppressive therapy are vital for favorable outcomes in anti-LGI1 encephalitis.
  • Understanding the pathophysiology of sinus arrest aids in managing cardiac complications.
  • This case highlights the diverse neurological and systemic manifestations of autoimmune encephalitis.