Seizure semiology in leucine-rich glioma-inactivated protein 1 antibody-associated limbic encephalitis

Chen, Chao; Wang, Xiu; Zhang, Chao; Tao, Cui; Shi, Weixiong; Guan, Hongzhi; Ren, Haitao; Shao, Xiaoqiu

doi:10.1016/j.yebeh.2017.08.011

Cited by 33 publications

(28 citation statements)

References 28 publications

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“…However, to date, the origin of FBDS remains controversial. Cortical, subcortical, and cortical-subcortical origins have been supported by different studies, respectively (3,16,17,19,20). In the present study, the ictal EEG of FBDS showed suppression of amplitude in all the electrodes 1 s before onset, indicating that it was epileptic in nature.…”

Section: The Clinical and Eeg Features Of Seizures In Lgi1 Aesupporting

confidence: 77%

“…These results were consistent with previous studies (5,6,(11)(12)(13)(14)(15), which showed that 90% of the patients with LGI1 AE had seizures that mainly present in three types: FBDS, MTLElike seizure, and FBTCS (11)(12)(13)(14). In a recent study, patients with LGI1 AE were divided into the following three groups based on seizure semiology: FBDS only (FBDS-only), epileptic seizure without FBDS (non-FBDS, mainly manifested MTLElike semiology), and coexistence of FBDS and other seizure (FBDS+) (16). FBDS is the most specific seizure type in LGI1 AE, which presents in approximately half of the patients (11-13, 17, 18).…”

Section: The Clinical and Eeg Features Of Seizures In Lgi1 Aementioning

confidence: 99%

“…Combined with imaging findings (brain MRI showed high T1/T2 signal on the unilateral basal ganglia), the origin of FBDS was considered subcortical basal ganglia. Previous studies have found that 66-89% of patients with LGI1 AE have MTLElike seizure (3,11,13,16,21,22), which are characterized by fear, epigastric rising, staring, and automatisms. The frequency of this kind of seizure is more frequent than that of classic MTLE, and the duration is relatively shorter (16), which are consistent with our study.…”

Section: The Clinical and Eeg Features Of Seizures In Lgi1 Aementioning

confidence: 99%

“…Previous studies have found that 66-89% of patients with LGI1 AE have MTLElike seizure (3,11,13,16,21,22), which are characterized by fear, epigastric rising, staring, and automatisms. The frequency of this kind of seizure is more frequent than that of classic MTLE, and the duration is relatively shorter (16), which are consistent with our study. The differences in seizure semiology between LGI1 AE and classic MTLE may be attributed to different pathogenic mechanisms (16,23,24).…”

Section: The Clinical and Eeg Features Of Seizures In Lgi1 Aementioning

confidence: 99%

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Clinical and Electroencephalographic Features of the Seizures in Neuronal Surface Antibody-Associated Autoimmune Encephalitis

Wang

et al. 2020

Front. Neurol.

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Objectives: To investigate clinical and electroencephalographic features of the seizures in different types of neuronal surface antibody (NSAb)-associated autoimmune encephalitis (AE). Methods: The clinical data of the seizures were analyzed in 18 patients with NSAb-associated AEs diagnosed in the First Affiliated Hospital of Dalian Medical University. Results: From May 2013 to April 2019, a total of 18 cases of NSAb-associated AE were diagnosed, including 9 cases of leucine-rich glioma-inactivated 1 protein (LGI1) antibody-associated encephalitis, 7 cases of anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis, and 2 cases of anti-γ-aminobutyric acid B receptor (GABA B R) encephalitis. All nine cases (100%) with LGI1 AE had seizures manifesting in three types: faciobranchial dystonia seizure (FBDS) (44.4%), mesial temporal lobe epilepsy (MTLE)-like seizure (66.7%), and focal to bilateral tonic-clonic seizure (FBTCS) (77.8%). Six of nine (66.7%) showed abnormal signal on hippocampus or basal ganglia in brain MRI. Five of seven cases (71%) with anti-NMDAR encephalitis had seizures manifesting in three types: focal aware seizure (40%), focal-impaired awareness seizure (20%), generalized tonic-clonic seizure (GTCS) (100%), and status epilepticus (SE) (40%). Three of seven (42.8%) showed abnormalities in brain MRI. Both patients with anti-GABA B R encephalitis had seizures manifesting in two types: GTCS and MTLE-like seizure, one with SE. One showed abnormal signal on left hippocampus in brain MRI. All patients (100%) with three types of AE had abnormalities in electroencephalogram (EEG), showing diffuse (4/18) or focal slow waves (14/18) in background, interictal (10/18), or ictal (6/18) epileptic discharges in the temporal or other regions; two patients with anti-NMDAR encephalitis showed delta activity or rhythm in frontotemporal region. All patients with seizures showed good response to immunotherapy except one with LGI1 AE. Conclusions: Most patients with NSAb-associated AE had seizures; seizure types varied between different types of AE. In LGI1 AE, the hippocampus and basal ganglia were two main targets; the corresponding seizure type was MTLE-like seizure and FBDS, respectively. Anti-NMDAR encephalitis had more generalized than focal seizures. Wang et al. Seizure Features in Autoimmune Encephalitis Delta activity or rhythm in the frontotemporal region in EEG was helpful for diagnosis. Anti-GABA B R encephalitis was characterized by refractory seizures as initial symptom, mainly GTCS or MTLE-like seizure. Most seizures in NSAb-associated AE showed good response to immunotherapy, and antiepileptic drugs should be considered as an add-on symptomatic treatment.

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Section: The Clinical and Eeg Features Of Seizures In Lgi1 Aesupporting

confidence: 77%

Section: The Clinical and Eeg Features Of Seizures In Lgi1 Aementioning

confidence: 99%

Section: The Clinical and Eeg Features Of Seizures In Lgi1 Aementioning

confidence: 99%

Section: The Clinical and Eeg Features Of Seizures In Lgi1 Aementioning

confidence: 99%

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Clinical and Electroencephalographic Features of the Seizures in Neuronal Surface Antibody-Associated Autoimmune Encephalitis

Wang

et al. 2020

Front. Neurol.

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“…Amnesia, confusion, and seizure are the main symptoms of LGI1-related LE. Recently, another distinctive symptom involving brief, very frequent episodes that typically involve dystonic posturing of the hemiface and ipsilateral arm (faciobrachial dystonic seizures, FBDS) has been described and is currently viewed as pathognomonic for the presence of LGI1 antibodies [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

LGI-1 antibody associated limbic encephalitis in a Brazilian woman with faciobrachial dystonic seizures

Dagv¹,

Phang²,

Da³

et al. 2018

Clin Med Rep

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Anti‐LGI1, anti‐GABABR, and Anti‐CASPR2 encephalitides in Asia: A systematic review

et al. 2020

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Seizure semiology in leucine-rich glioma-inactivated protein 1 antibody-associated limbic encephalitis

Cited by 33 publications

References 28 publications

Clinical and Electroencephalographic Features of the Seizures in Neuronal Surface Antibody-Associated Autoimmune Encephalitis

Clinical and Electroencephalographic Features of the Seizures in Neuronal Surface Antibody-Associated Autoimmune Encephalitis

LGI-1 antibody associated limbic encephalitis in a Brazilian woman with faciobrachial dystonic seizures

Anti‐LGI1, anti‐GABABR, and Anti‐CASPR2 encephalitides in Asia: A systematic review

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