An adolescent case of limbic encephalitis with anti leucine-rich glioma inactivated 1 antibodies

Abstract

Background: Limbic encephalitis associated with leucine-rich glioma inactivated 1 (LGI1) antibodies can initially have either neurological or psychiatric manifestation. Subject and methods: The paper describes a case of a 14-year old girl with LGI1 antibodiesassociated limbic encephalitis with initial symptoms suggesting psychotic disturbances. Results: The magnetic resonance imaging (MRI) of the head was normal and the electroencephalography (EEG) presented low voltage with inter-hemispheric asymmetry and paroxysmal series of delta and theta waves. Blood antibody tests detected the presence of the LGI1 antibodies. Apart from psychotic symptoms, the patient also presented epileptic seizures, instability of the autonomous nervous system, dysphagia and catatonia. Initial treatment with antipsychotics resulted in the neuroleptic malignant syndrome (NMS). Significant improvement of the patient's condition appeared upon the administration of immunoglobulins and methylprednisolone. Conclusions: Diagnosis and treatment of the limbic encephalitis in the young patient may be difficult due to a variety of reasons. A determination of anti-LGI1 antibodies also in adolescents presenting psychotic symptoms may be considered.

LGI‐1 antibody encephalitis in a seven‐year‐old girl

“…LGI‐1 limbic encephalitis has been reported predominantly in adults with a mean age at onset of around 63 years (Li et al, 2018a). Janas‐Kozik et al reported a case of a 14‐year‐old adolescent girl with limbic encephalitis associated with LGI‐1 antibodies who presented with seizures, autonomic instability, and psychotic symptoms (Janas‐Kozik et al, 2017). To our knowledge, our patient is the youngest case ever reported in the literature and highlights the importance to consider this diagnosis also in children.…”

Leucine-rich Glioma Inactivated 1 (LGI-1) Limbic Encephalitis Presenting with Psychotic Symptoms without Seizures: A Case Report with Five-year Follow-up and Review of Literature

“…These models effectively improve the screening of perinatal women for depression using the Patient Health Questionnaire (PHQ-2 or PHQ-9) in tertiary care settings 13 and can be included as community-based assessments (e.g., Community Based Assessment Checklist in India) and part of national programs. 14 However, there are various challenges for the implementation of these interventions/models in resource-limited settings, including limited training resources, overburdened primary HCWs with multiple responsibilities under different programs, and difficulty maintaining records and arranging follow-ups. Most of these issues, however, can be addressed by innovative technology-based interventions.…”

NMDA Receptor Model of Antipsychotic Drug-Induced Hypofrontality

“…Still, parts of some studies do not show any abnormalities, e.g., [56]. Some patients suffering from the initial phase of NMDAR autoimmune encephalitis with NR1 antibodies may exhibit schizophrenia-like psychotic behavior [60,61] or symptoms of hypofrontality [62], however, the vast majority of recent studies do not confirm the presence of IgG-NR1 antibodies in schizophrenia [63,64].…”