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May 29, 2013
LGI1 Antibodies in Limbic Encephalitis
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.
Submitted by Adam Numis MD, Resident Physician, University of California, San Francisco.
Disclosure: Dr. Numis serves on the editorial team for the Neurology® Resident and Fellow Section.
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