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Abstract Details

Anti-IgLON5 Presenting as Cervical Dystonia
Autoimmune Neurology
P5 - Poster Session 5 (5:30 PM-6:30 PM)
14-016
To report a case of anti-IgLON5 disease demonstrating cervical dystonia as part of the clinical picture.
Anti-IgLON5 disease is a rare autoimmune encephalitis first documented in 2014 and has a frequency of being found in approximately 1 out of 150,000 patients. The typical presentation for this condition is parasomnia, gait difficulty, and bulbar dysfunction, however it can manifest initially with movement disorder. It is however rarer to present as anterior cervical dystonia as one of the prominent symptoms.
Case Report
We present a case of 67-year-old male with initial symptoms in early 2022 of thumping in the chest. Later, balance problems followed in late 2022, and around the beginning of 2023, there was progressive onset of anterior cervical dystonia with associated progression of encephalopathy and parasomnia. At this time, the patient also began to have developed a tremor in his hands.. A neurodiagnostic workup was completed including lumbar puncture and MRI brain, which were nonspecific. In early 2023, his disease had progressed with worsening central apnea leading to sudden episodes of respiratory arrest. The CSF results yielded positivity for IgLON5 antibodies. CSF results also showed an elevated protein of 98 and 7 WBCs with 100% lymphocytes. An EEG in June 2023 showed occasional left temporal lobe slowing. The patient was treated with IVIG, PLEX, and rituximab which provided a modest improvement in symptoms. 
We present a unique case of anterior cervical dystonia in a patient with the rare autoimmune condition of anti-IgLON5 disease. This was a slowly progressive case with the diagnosis made through positive CSF IgLON5 antibodies. Anti-IgLON5 is a heterogeneous disease. This case adds the presentation of cervical dystonia to the list of potential clinical manifestations of this disease. 
Authors/Disclosures
Matthew D. Collin, DO
PRESENTER 		Dr. Collin has nothing to disclose.
Miriam Quinlan, MD, MPH Dr. Quinlan has nothing to disclose.
Gwen W. Zeigler, DO (Albany Medical College) Dr. Zeigler has received personal compensation in the range of $0-$499 for serving as a Speaker with American College of Osteopathic Neurologists and Psychiatrists Mid-Year Meeting. Dr. Zeigler has received personal compensation in the range of $500-$4,999 for serving as a Speaker with 好色先生. Dr. Zeigler has received personal compensation in the range of $0-$499 for serving as a Speaker with QueerDoc. Dr. Zeigler has received personal compensation in the range of $0-$499 for serving as a Speaker with American Osteopathic Association/Osteopathic Medical 好色先生 Conference.
Panayiotis N. Varelas, MD, PhD, FAAN (Albany Med-Department of Neurology) Dr. Varelas has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for UCB. Dr. Varelas has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Astra Zeneca -Alexion - Portola. Dr. Varelas has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Annexon. Dr. Varelas has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Astra Zeneca- Alexion-Portola. Dr. Varelas has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Marinus. Dr. Varelas has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Annexon. Dr. Varelas has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Giammarco, Mullins & Horton P.C. The institution of Dr. Varelas has received research support from Marinus. The institution of Dr. Varelas has received research support from Bayer. Dr. Varelas has received publishing royalties from a publication relating to health care. An immediate family member of Dr. Varelas has received personal compensation in the range of $5,000-$9,999 for serving as a Rep to the RUC meeting with AAN. Dr. Varelas has received personal compensation in the range of $500-$4,999 for serving as a Speaker at the Annual Meeting with AAN. Dr. Varelas has a non-compensated relationship as a President - Past President with Neurocritical Care Society that is relevant to AAN interests or activities.