LGI1 positive paraneoplastic limbic encephalitis: A case report of atypical presentation

Abstract

Limbic encephalitis is a rare disorder mainly affecting the medial temporal lobe and is classically paraneoplastic. Autoimmune etiologies also exist, such as antibodies against leucine-rich glioma activated 1 (LGI1). Most cases of anti-LGI1 encephalitis are not associated with tumors. Subacute memory loss is the predominant feature, and most patients develop focal seizures, especially faciobrachial dystonic seizures (FBDSs). Immunotherapies usually show a good response, but are less effective in paraneoplastic cases. We report a case of steroid-responsive anti-LGI1 encephalitis with atypical presentations of sensory aphasia during relapse from rectal carcinoma, an atypical site.