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Abstract Details

Anti LGI1 Encephalitis–A Retrospective Analysis of Clinical Features and Treatment Response
Autoimmune Neurology
Autoimmune Neurology Posters (7:00 AM-5:00 PM)
074

To analyze the clinical phenotype, treatment response & short term prognosis of anti LGI1 encephalitis

Autoimmune encephalitis are important treatable causes of encephalitis. Phenotype recognition and knowledge of treatment responses of specific autoimmune encephalitis help us in diagnosis and long term management

Retrospective study  of  six antibody proven cases of antiLGI1 encephalitis  treated in a tertiary care center between  June 2017 to May 2020 were recruited. Analysis of their clinical features, movement disorder patterns, investigations, MRI, treatment schedules and follow up were done.

Six cases of anti LGI1 encephalitis ( 3 females , 3 males ) were recruited. Age varied between 22 and 62.Mean duration of presentation to hospital was 22 days. 83%(5/6) had Faciobrachial dystonic seizures (FBDS) and one patient had paroxysmal kinesogenic dyskinesia with episodic piloerection.       33 %(2/6) had encephalopathy, episodic memory disturbances, hyponatremia and  CSF pleocytosis. One patient had CPS. Two patients had sleep disturbance. EEG showed theta slowing in 50%, no epileptiform activity seen.83% patients showed MRI changes of limbic encephalitis.   

 All received 5 pulses of 1g IV methylprednisolone followed by oral wysolone 1mg/kg. Remission achievement varied from 2 weeks to 4weeks. Oral steroids were tapered and stopped between a period of 5 to 7 months.    Azathioprine 2mg/kg was given along with steroid  to 5/6patients.Azathioprine was stopped at the end of 1 year. No patient received IVIG or PLEX .Patients also received AEDS (Oxcarbazepine 4/6, valproate 2/6 and Clonazepam 4/6).One patient received Risperidone a. AEDs were tapered in 6 months in all except the one with seizure where it was tapered after 1 year .No relapses were seen .Post treatment remission periods varies between 3 months and 2 years

Anti LGI1 encephalitis has a classic phenotype   with FBDS, encephalopathy, episodic memory disturbance, hyponatremia and MRI showing limbic encephalitis.  Anti LGI 1 encephalitis   responds very well to first line immunotherapy
Authors/Disclosures
Suresh Chandran, MD (Kerala Institute of Medical Sciences)
PRESENTER
Dr. Chandran has nothing to disclose.