• the Korean Society for Brain and Neural Sciences


Case Report

Exp Neurobiol 2013; 22(4): 337-340

Published online December 30, 2013

© The Korean Society for Brain and Neural Sciences

Anti-LGI1 Limbic Encephalitis Presented with Atypical Manifestations

Jung-Ju Lee1, Soon-Tae Lee2, Keun-Hwa Jung2, Kon Chu2 and Sang Kun Lee2*

1Department of Neurology, Eulji General Hospital, Eulji University College of Medicine, Seoul 139-872, 2Department of Neurology, Comprehensive Epilepsy Center, Biomedical Research Institute, Seoul National University Hospital, Seoul 110-744, Korea

Correspondence to: *To whom correspondence should be addressed.
TEL: 82-2-2072-2923, FAX: 82-2-2072-7424

Received: December 2, 2013; Revised: December 19, 2013; Accepted: December 19, 2013


Anti-leucine-rich glioma inactivated-1 (LGI1) limbic encephalitis (LE) is a rare neurological disorder that has a subacute course of progressive encephalopathy and fasciobrachial dystonic seizures. We report a patient with anti-LGI1 LE that presented with atypical manifestations that complicated the diagnosis. A 62-year-old woman presented with a chronic course of memory disturbance and a subsequent relapse with an altered mental status after 10 months. The patient reported frequent chest pain of squeezing and dull nature, typically lasting 10-30 seconds. The chest pain was related to partial seizures, which were confirmed by video-EEG monitoring. Anti-LGI1 antibody was identified in serum and CSF. The patient's symptoms improved by immune modulation treatment. Patients with anti-LGI1 LE can experience atypical partial seizures, and a chronic relapsing course. Clinical suspicions and video-EEG monitoring are helpful for the early diagnosis and effective immune modulation.

Keywords: limbic encephalitis, chest pain, seizure, immune