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Advanced Neurology

REVIEW ARTICLE
Anti-leucine-rich glioma inactivated-1

autoimmune encephalitis: A review of diagnosis
and treatment

1†
1†
Ning Gu , Tian-Yue Meng , Zhuang Zhu , Bao-Xin Wu , Ying-Feng Mu , and
3
2†
1†
De-Qin Geng *
3
1 School of Clinical Medicine, Xuzhou Medical University, Xuzhou, China
2 Department of Neurology, Peixian People’s Hospital, Xuzhou, China
3 Department of Neurology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China

Abstract
Anti-leucine-rich glioma inactivated-1 (LGI1) autoimmune encephalitis is the second
most common autoimmune encephalitis, usually with acute or subacute onset.
The rates of misdiagnosis and missed diagnosis are high because of its insidious
onset. We review the pathogenesis, clinical manifestations, differential diagnosis,
treatment, and prognosis of anti-LGI1 autoimmune encephalitis, so as to provide
references for clinicians to understand this disease. This disease presents with a
variety of clinical manifestations, including faciobrachial dystonic seizure (FBDS),
cognitive impairment, hyponatremia, hyperkinetic movements (HMs), and mental
† These authors contributed equally
18
18
to this work. impairment. F-fluorodeoxyglucose position emission tomography ( F-FDG PET)
has higher sensitivity than magnetic resonance imaging (MRI) and can be used to
*Corresponding author:
De-Qin Geng measure disease activity and assess patient response to treatment. The detection
(gengdeqin@126.com) of LGI1 antibodies in cerebrospinal fluid or serum is a confirmatory test. The rapid
initiation of immunotherapy after diagnosis can significantly improve the prognosis
Citation: Gu N, Meng T, Zhu Z,
et al., 2022, Anti-leucine-rich of patients.
glioma inactivated-1 autoimmune
encephalitis: A review of diagnosis
and treatment. Adv Neuro, 1(3): 237. Keywords: Autoimmune encephalitis; Leucine-rich glioma-inactivated-1; Faciobrachial
https://doi.org/10.36922/an.v1i3.237 dystonic seizure; Immunotherapy
Received: October 25, 2022
Accepted: December 9, 2022
Published Online: December 27, 1. Introduction
2022
Autoimmune encephalitis (AE) generally refers to a type of encephalitis that is mediated by
Copyright: © 2022 Author(s).
This is an Open Access article autoimmune mechanisms. AE can be divided into three main types according to different
distributed under the terms of the anti-neuronal antibodies and their corresponding clinical syndromes: anti-N-methyl-D-
Creative Commons Attribution aspartate receptor (NMDAR) encephalitis, limbic encephalitis (including anti-leucine-
License, permitting distribution,
and reproduction in any medium, rich glioma inactivated-1 [LGI1] antibody, anti-γ-aminobutyric acid type B receptor
provided the original work is [GABA R] antibody, and anti-α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid
B
properly cited. receptor [AMPAR] antibody-related encephalitis), and other AE syndromes . LGI1 is
[1]
Publisher’s Note: AccScience a neuronal secretory glycoprotein, mainly expressed in the hippocampus and temporal
Publishing remains neutral with lobe cortex. It participates in the development and physiological function of the central
regard to jurisdictional claims in [2]
published maps and institutional nervous system . LGI1 antibody-associated limbic encephalitis was discovered by Irani
[2]
affiliations. et al. in 2010, accounting for about 25% of autoimmune encephalitis . It is common in

Volume 1 Issue 3 (2022) 1 https://doi.org/10.36922/an.v1i3.237