Table 1.
Clinical manifestations of eight patients with LGI1 antibody encephalitis
| Characteristic | Case1 | Case2 | Case3 | Case4 | Case5 | Case6 | Case7 | case8 |
|---|---|---|---|---|---|---|---|---|
| Sex | Male | Male | Female | Female | Male | Male | Female | Male |
| Age (years) | 64 | 69 | 60 | 63 | 67 | 73 | 41 | 70 |
| Onset to visit (days) | 60 | 45 | 300 | 15 | 20 | 10 | 150 | 30 |
| Initial symptoms | FBDS (50/d) | FBDS(20/d) | Tonic-clonic seizures(12 in total), | Tonic-clonic seizures(5 in total), | Memory deficit, | Memory deficit, | FBDS(100/d) | FBDS(40/d) |
| Other symptoms | Memory deficit, Partial seizures(arrector pili muscle contraction) Sleep disorder, Autonomic disorders (Sexual dysfunction, sinus bradycardia with chest tightness) | Memory deficit, Tonic-clonic(2 in total), partial seizures(3–5/d) Hallucination(visual+ auditory) Spatial disorientation, Sleep disorder, Ataxia, Autonomic disorders(sweating) | Memory deficit, Hallucinations(auditory) Spatial disorientation, Sleep disorder, Emotional changes (irritability,indifference), Autonomic disorders (Bradycardia) | FBDS(70/d), Memory deficit, Spatial disorientation, Hallucination(visual+ auditory), Emotional changes (indifference) | Partial seizures(10–15/d) Hallucination(visual+ auditory), Sleep disorder | FBDS(50/d) Spatial disorientation Emotional changes (indifference) | Memory deficit, Emotional change (anxiety, irritability suspiciousness) | Memory deficit, Emotional change (anxiety) |
| MMSE score (0–30)(Education) | University | high school | high school | high school | University | University | University | high school |
| Admission misse points | 26 recall (1) calculation(1) orientation(1) complex commands (1) | 16 recall (3) calculation (3) orientation (3)repetition (1) complex commands (4) | 18 recall (3) calculation (3) orientation (2) repetition (1) complex commands(3) | 15 registration (1) recall (3) calculation (3) orientation (3) repetition (1) complex commands(4) | 20 recall (2) calculation (2) orientation (3) complex commands(3) | 22 recall (2) calculation (1) orientation (1) complex commands(4) | 23 recall (2) calculation (2) orientation (1) complex commands(2) | 14 registration (1) recall (3) calculation (3) orientation (3) repetition (1) complex commands(5) |
| Discharge misse points | 30 | 23 recall (2) calculation (1) orientation (1) complex commands (3) | 28 recall (1) complex commands(1) | 26 recall (1) calculation (1) orientation (1) complex commands(1) | 25 recall (1) calculation (1) orientation (1) complex commands(2) | 28 recall (1) orientation (1) | 29 recall (1) | 26 recall (1) calculation (1) orientation (1) complex commands(1) |
| LGi1 antibody (serum) | 1:10 (before admission) 1:32 (after admission) | 1:32 | 1:32 | 1:10 | 1:32 | 1:32 | 1:100 | 1:32 |
| LGi1 antibody (CSF) | 1:1 | – | – | 1:1 | 1:3.2 | 1:1 | – | – |
| Blood sodium (normal 135–155 mmol/L) | 135.1 | 130 | 127.9 | 126 | 131.4 | 121.2 | 132 | 140 |
| White blood cell (CSF) (normal 0–5 × 106/L) | 4 | – | – | 2 | 10 | 2 | – | – |
| Protein(CSF) (normal 0.15–0.45 g/L) | 0.25 | – | – | 0.31 | 0.46 | 0.28 | – | – |
| Glucose(CSF)(normal 2.5–4.5 mmol/L) | 3.5 | – | – | 4.07 | 3.91 | 4.1 | – | – |
| Brain MRI | Right insula | Norma | Bilateral hippocampus | Bilateral caudate nucleus+ putamen | Right hippocampus | Normal | Right caudate nucleus | Normal |
| EEG | Normal | Normal | Normal | Diffuse slow wave (4-6 Hz) | Paroxysmal spike-slow wave (right frontal lobe,middle and posterior temporal lobe) | Normal | Normal | Normal |
| AEDs | Levetiracetam Lamotrigine | Sodium valproate | Sodium valproate | Sodium valproate | Levetiracetam | Levetiracetam | Sodium valproate | Sodium valproate |
| Immunotherapy | methylprednisolone +Gamma globulin | methylprednisolone | methylprednisolone | methylprednisolone +Gamma globulin | methylprednisolone +Gamma globulin | methylprednisolone + Gamma globulin | methylprednisolone | methylprednisolone |
| Symptoms at discharge | FBDS disappeared | FBDS reduction | No seizures | FBDS disappeared | No seizures | FBDS disappeared | FBDS disappeared | FBDS disappeared |
| Length of stay(days) | 13 | 15 | 16 | 12 | 21 | 25 | 17 | 15 |
| Follow up time(months) | 4 | 4 | 7 | 6 | 6 | 13 | 4 | 4 |
| serum antibody follow up | 1:10 | – | 1:32 | – | – | – | – | – |
| Relapse(months) | No | No | No | 1 | No | 3 | No | No |
| Remaining symptoms | amnesia | amnesia Spatial disorientation | amnesia Insomnia | amnesia | Insomnia | amnesia Spatial disorientation | No | amnesia |
| AEDs | No | Sodium valproate | Sodium valproate | Sodium valproate | Levetiracetam | Levetiracetam | Sodium valproate | Sodium valproate |
| Seizure | No | No | No | No | Occasionally(absence seizures) | No | No | No |
‘–’, No test information;
Abbreviations: CSF cerebrospinal fluid, FBDS faciobrachial dystonic seizure, MMSE Mini-Mental State Examination, LGI1 leucine-rich glioma-inactivated 1, AEDs antiepileptic drugs, EEG electroencephalography