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

页码：127 / 130

页数：4

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