Unexplicated neuropsychiatric disorders: Do not ignore dysimmune encephalitis. A case report of a dysimmune encephalitis with anti-leucine rich glioma inactivated 1 (LGI-1) antibodies

被引：4
作者：
Le Dault, E. [1 ]
Lagarde, S. [2 ]
Guedj, E. [3 ]
Dufournet, B. [4 ]
Rey, C. [4 ]
Kaphan, E. [4 ]
Tanguy, G. [2 ]
Bregigeon, M. [2 ]
Sagui, E. [2 ]
Brosset, C. [2 ]
机构：
[1] Hop Instruct Armees Laveran, Serv Pathol Infect & Trop, 34 Blvd Alphonse Laveran, F-13014 Marseille, France
[2] Hop Instruct Armees Laveran, Serv Neurol, 34 Blvd Alphonse Laveran, F-13014 Marseille, France
[3] CHU Timone, AP HM, Serv Med Nucl, 264 Rue St Pierre, F-13385 Marseille, France
[4] CHU Timone, AP HM, Serv Neurol, 264 Rue St Pierre, F-13385 Marseille, France
来源：
REVUE DE MEDECINE INTERNE | 2016年 / 37卷 / 02期
关键词：
Dysimmune encephalitis; Autoimmune encephalitis; Leucine rich glioma inactivated 1 (LGI-1); Voltage gate potassium channel (VGKC); Facio-brachial dystonic seizures; POTASSIUM-CHANNEL ANTIBODY; FACIOBRACHIAL DYSTONIC SEIZURES; LIMBIC ENCEPHALITIS; IMMUNOTHERAPY; MANIFESTATIONS; AUTOIMMUNITY; PROTEIN;
D O I：
10.1016/j.revmed.2015.06.007
中图分类号：
R5 [内科学];
学科分类号：
1002 ; 100201 ;
摘要：
Introduction. - Anti-leucine rich glioma inactivated 1 encephalitis is a common and a treatable etiology of autoimmune encephalitis. Its diagnosis is a challenge because the initial diagnostic work-up is often normal. Case report. - A 48-year-old man experienced cognitive and behavioral troubles, facio-brachial dystonic seizures and a syndrome of inappropriate antidiuretic hormone secretion. First line tests excluded infectious, neoplastic, systemic inflammatory, endrocrine or toxic etiologies. Cerebral (18)Fluoro-desoxy-glucose (FDG) position emission tomography and research of specific antibodies in cerebro-spinal fluid and serum led to diagnose an anti-leucine rich glioma inactivated 1 encephalitis. Intravenous immunoglobulins and corticosteroids were partially effective. Cyclophosphamid permitted a good recovery. Conclusion. - In the presence of acute neuropsychiatric disorders with a negative etiologic research, physician should think about dysimmune encephalitis. Facio-brachial dystonic seizures and syndrome of inappropriate antidiuretic hormone secretion are highly evocative of anti-leucine rich glioma inactivated 1 encephalitis. The diagnosis needs specific diagnostic tests (cerebral (18)FDG position emission tomography and antibodies research in cerebro-spinal fluid and in serum), after the exclusion of alternative diagnoses. Extensive and repeated diagnostic work-up for neoplasia is required. Immunosupressive therapies are effective in most cases. (C) 2015 Societe nationale francaise de medecine interne (SNFMI). Published by Elsevier Masson SAS. All rights reserved.
引用
收藏
页码：127 / 130
页数：4
相关论文
共 21 条
  • [1] Autoimmune encephalitis, clinical, radiological and immunological data
    Aupy, J.
    Collongues, N.
    Blanc, F.
    Tranchant, C.
    Hirsch, E.
    De Seze, J.
    [J]. REVUE NEUROLOGIQUE, 2013, 169 (02) : 142 - 153
  • [2] Adult-onset drug-refractory seizure disorder associated with anti-voltage-gated potassium-channel antibody
    Barajas, Ramon F.
    Collins, D. Eric
    Cha, Soonmee
    Geschwind, Michael D.
    [J]. EPILEPSIA, 2010, 51 (03) : 473 - 477
  • [3] FDG-PET and MRI in potassium channel antibody-associated non-paraneoplastic limbic encephalitis: correlation with clinical course and neuropsychology
    Fauser, S
    Talazko, J
    Wagner, K
    Ziyeh, S
    Jarius, S
    Vincent, A
    Schulze-Bonhage, A
    [J]. ACTA NEUROLOGICA SCANDINAVICA, 2005, 111 (05): : 338 - 343
  • [4] Improvement of non-paraneoplastic voltage-gated potassium channel antibody-associated limbic encephalitis without immunosuppressive therapy
    Gast, Heidemarie
    Schindler, Kaspar
    Z'Graggen, Werner J.
    Hess, Christian W.
    [J]. EPILEPSY & BEHAVIOR, 2010, 17 (04) : 555 - 557
  • [5] Rapidly progressive dementia
    Geschwind, Michael D.
    Shu, Huidy
    Haman, Aissa
    Sejvar, James J.
    Miller, Bruce L.
    [J]. ANNALS OF NEUROLOGY, 2008, 64 (01) : 97 - 108
  • [6] Therapeutic approaches in antibody-associated central nervous system pathologies
    Honnorat, J.
    [J]. REVUE NEUROLOGIQUE, 2014, 170 (10) : 587 - 594
  • [7] Cell-Surface Central Nervous System Autoantibodies: Clinical Relevance and Emerging Paradigms
    Irani, Sarosh R.
    Gelfand, Jeffrey M.
    Al-Diwani, Adam
    Vincent, Angela
    [J]. ANNALS OF NEUROLOGY, 2014, 76 (02) : 168 - 184
  • [8] Faciobrachial dystonic seizures: the influence of immunotherapy on seizure control and prevention of cognitive impairment in a broadening phenotype
    Irani, Sarosh R.
    Stagg, Charlotte J.
    Schott, Jonathan M.
    Rosenthal, Clive R.
    Schneider, Susanne A.
    Pettingill, Philippa
    Pettingill, Rosemary
    Waters, Patrick
    Thomas, Adam
    Voets, Natalie L.
    Cardoso, Manuel J.
    Cash, David M.
    Manning, Emily N.
    Lang, Bethan
    Smith, Shelagh J. M.
    Vincent, Angela
    Johnson, Michael R.
    [J]. BRAIN, 2013, 136 : 3151 - 3162
  • [9] Faciobrachial Dystonic Seizures Precede Lgi1 Antibody Limbic Encephalitis
    Irani, Sarosh R.
    Michell, Andrew W.
    Lang, Bethan
    Pettingill, Philippa
    Waters, Patrick
    Johnson, Michael R.
    Schott, Jonathan M.
    Armstrong, Richard J. E.
    Zagami, Alessandro S.
    Bleasel, Andrew
    Somerville, Ernest R.
    Smith, Shelagh M. J.
    Vincent, Angela
    [J]. ANNALS OF NEUROLOGY, 2011, 69 (05) : 892 - 900
  • [10] Antibodies to Kv1 potassium channel-complex proteins leucine-rich, glioma inactivated 1 protein and contactin-associated protein-2 in limbic encephalitis, Morvan's syndrome and acquired neuromyotonia
    Irani, Sarosh R.
    Alexander, Sian
    Waters, Patrick
    Kleopa, Kleopas A.
    Pettingill, Philippa
    Zuliani, Luigi
    Peles, Elior
    Buckley, Camilla
    Lang, Bethan
    Vincent, Angela
    [J]. BRAIN, 2010, 133 : 2734 - 2748
123