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Updated: Sep 13, 2025
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Hippocampal Neuronal Cultures to Detect and Study New Pathogenic Antibodies Involved in Autoimmune Encephalitis
Published on: June 2, 2022
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When the Mind Plays Tricks: LGI1 Encephalitis Mimicking Psychiatric Illness
Akshayaa K Aggarawal1, Jithun V Varghese1, Mansoor Gazi1
1Internal Medicine, Walsall Manor Hospital, Walsall, GBR.
Cureus
|July 28, 2025
Summary
Leucine-rich glioma inactivated 1 (LGI1) antibody-associated autoimmune encephalitis (AE) can present atypically. Early diagnosis and corticosteroid treatment improved cognitive decline and spasms in a 66-year-old man.
Area of Science:
- Neurology
- Immunology
- Neuroscience
Background:
- Autoimmune encephalitis (AE) is a rare neurological disorder caused by the immune system attacking the brain.
- Leucine-rich glioma inactivated 1 (LGI1) antibody-associated AE is a subtype more prevalent in older males, often presenting with cognitive impairment and faciobrachial dystonic seizures (FBDS).
Observation:
- A 66-year-old male with hypertension and hyperlipidemia presented with confusion, cognitive decline, and sleep-related spasms.
- Initial brain magnetic resonance imaging (MRI) and electroencephalogram (EEG) were unremarkable, leading to diagnostic delays.
- Subsequent serological testing revealed the presence of LGI1 antibodies.
Findings:
- The patient received corticosteroid therapy, resulting in significant cognitive improvement and a reduction in confusion episodes.
- Family members reported a decrease in the patient's spasms following treatment.
Implications:
- This case underscores the importance of considering LGI1 antibody-associated AE in patients with unexplained neurological symptoms, even with normal initial investigations.
- Early detection and prompt initiation of immunotherapy, such as corticosteroids, are crucial for favorable outcomes in LGI1 antibody-associated AE.
- Highlights the need for comprehensive diagnostic workup in suspected autoimmune neurological conditions.
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