Suspected LGI1 Autoimmune Encephalitis With Basal Ganglia and Insular MRI Abnormalities
A Case Report
DOI:
https://doi.org/10.59667/sjoranm.v24i1.16Keywords:
autoimmunity, auto-antibodies, epilepsy, myoclonic seizures, cognitive dysfunction, sleep disturbances, steroids, LGI1 encephalitisAbstract
A 73-year-old man presented after recurrent involuntary movements involving the arm and face, followed by an episode concerning for seizure. Hyponatremia and episodic movements raised suspicion for an autoimmune process. Brain MRI showed evolving left basal ganglia abnormalities and a new left insular signal abnormality. The differential diagnosis included ischemia and autoimmune encephalitis. The treating team favored LGI1 autoimmune encephalitis and administered high-dose corticosteroids and intravenous immunoglobulin. The report describes clinical improvement and resolution of the illustrated MRI abnormalities after treatment. The case illustrates the role of clinical chronology and serial imaging when focal MRI abnormalities initially raise concern for stroke.
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