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Anti-leucine-rich Glioma-inactivated 1 Encephalitis Manifesting as Frequent Ictal Pouting and Subtle Memory
Takeshi Araki1, Hajime Yoshimura1, Kenta Tsuchida1
1Department of Neurology, Kobe City Medical Center General Hospital, Japan.
Internal Medicine (Tokyo, Japan)
|September 29, 2024
Summary
Anti-leucine-rich glioma-inactivated 1 (LGI1) encephalitis can present subtly. This case highlights ictal pouting as a rare seizure symptom, emphasizing memory evaluation in older adults with focal seizures.
Area of Science:
- Neurology
- Immunology
Background:
- Anti-leucine-rich glioma-inactivated 1 (LGI1) encephalitis is a treatable autoimmune limbic encephalitis.
- It is characterized by focal seizures and cognitive decline, often affecting memory.
- Diagnosis can be challenging, especially with subtle cognitive impairment.
Purpose of the Study:
- To report a novel seizure manifestation (ictal pouting) in anti-LGI1 encephalitis.
- To emphasize the importance of recognizing subtle cognitive deficits in this condition.
- To highlight the diagnostic and therapeutic implications for middle-aged and older patients.
Main Methods:
- Case report of a 73-year-old male patient with anti-LGI1 encephalitis.
- Clinical observation of seizure semiology, including ictal pouting.
- Assessment of cognitive function, particularly visual memory.
- Evaluation of treatment response to steroids.
Main Results:
- The patient presented with subacute onset of frequent ictal pouting without obvious cognitive decline.
- Steroid treatment effectively resolved seizures.
- Subtle visual memory deficits improved following treatment.
- Ictal pouting was identified as a previously unreported seizure feature in anti-LGI1 encephalitis.
Conclusions:
- Ictal pouting can be a presenting seizure manifestation of anti-LGI1 encephalitis.
- Subtle memory disturbances may be present even without apparent cognitive decline.
- Thorough memory evaluation is crucial in middle-aged and older patients with subacute focal seizures.
- Anti-LGI1 antibody testing should be considered in suspected cases.
Keywords:
anti-leucine-rich glioma-inactivated 1 (LGI1) encephalitiscognitive declineictal poutingmemory disturbanceMore Related Videos
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