Table 1 Clinical manifestations of eight patients with LGI1 antibody encephalitis

Sex

Male

Male

Female

Female

Male

Male

Female

Male

Age (years)

64

69

60

63

67

73

41

70

Onset to visit (days)

60

45

300

15

20

10

150

30

Initial symptoms

FBDS (50/d)

FBDS(20/d)

Tonic-clonic seizures(12 in total),

Tonic-clonic seizures(5 in total),

Memory deficit,

Memory deficit,

FBDS(100/d)

FBDS(40/d)

Other symptoms

Memory deficit, Partial seizures(arrector pili muscle contraction) Sleep disorder, Autonomic disorders (Sexual dysfunction, sinus bradycardia with chest tightness)

Memory deficit, Tonic-clonic(2 in total), partial seizures(3–5/d) Hallucination(visual+ auditory) Spatial disorientation, Sleep disorder, Ataxia, Autonomic disorders(sweating)

Memory deficit, Hallucinations(auditory) Spatial disorientation, Sleep disorder, Emotional changes (irritability,indifference), Autonomic disorders (Bradycardia)

FBDS(70/d), Memory deficit, Spatial disorientation, Hallucination(visual+ auditory), Emotional changes (indifference)

Partial seizures(10–15/d) Hallucination(visual+ auditory), Sleep disorder

FBDS(50/d) Spatial disorientation Emotional changes (indifference)

Memory deficit, Emotional change (anxiety, irritability suspiciousness)

Memory deficit, Emotional change (anxiety)

MMSE score (0–30)(Education)

University

high school

high school

high school

University

University

University

high school

Admission misse points

26 recall (1) calculation(1) orientation(1) complex commands (1)

16 recall (3) calculation (3) orientation (3)repetition (1) complex commands (4)

18 recall (3) calculation (3) orientation (2) repetition (1) complex commands(3)

15 registration (1) recall (3) calculation (3) orientation (3) repetition (1) complex commands(4)

20 recall (2) calculation (2) orientation (3) complex commands(3)

22 recall (2) calculation (1) orientation (1) complex commands(4)

23 recall (2) calculation (2) orientation (1) complex commands(2)

14 registration (1) recall (3) calculation (3) orientation (3) repetition (1) complex commands(5)

Discharge misse points

30

23 recall (2) calculation (1) orientation (1) complex commands (3)

28 recall (1) complex commands(1)

26 recall (1) calculation (1) orientation (1) complex commands(1)

25 recall (1) calculation (1) orientation (1) complex commands(2)

28 recall (1) orientation (1)

29 recall (1)

26 recall (1) calculation (1) orientation (1) complex commands(1)

LGi1 antibody (serum)

1:10 (before admission) 1:32 (after admission)

1:32

1:32

1:10

1:32

1:32

1:100

1:32

LGi1 antibody (CSF)

1:1

–

–

1:1

1:3.2

1:1

–

–

Blood sodium (normal 135–155 mmol/L)

135.1

130

127.9

126

131.4

121.2

132

140

White blood cell (CSF) (normal 0–5 × 106/L)

4

–

–

2

10

2

–

–

Protein(CSF) (normal 0.15–0.45 g/L)

0.25

–

–

0.31

0.46

0.28

–

–

Glucose(CSF)(normal 2.5–4.5 mmol/L)

3.5

–

–

4.07

3.91

4.1

–

–

Brain MRI

Right insula

Norma

Bilateral hippocampus

Bilateral caudate nucleus+ putamen

Right hippocampus

Normal

Right caudate nucleus

Normal

EEG

Normal

Normal

Normal

Diffuse slow wave (4-6 Hz)

Paroxysmal spike-slow wave (right frontal lobe,middle and posterior temporal lobe)

Normal

Normal

Normal

AEDs

Levetiracetam Lamotrigine

Sodium valproate

Sodium valproate

Sodium valproate

Levetiracetam

Levetiracetam

Sodium valproate

Sodium valproate

Immunotherapy

methylprednisolone +Gamma globulin

methylprednisolone

methylprednisolone

methylprednisolone +Gamma globulin

methylprednisolone +Gamma globulin

methylprednisolone + Gamma globulin

methylprednisolone

methylprednisolone

Symptoms at discharge

FBDS disappeared

FBDS reduction

No seizures

FBDS disappeared

No seizures

FBDS disappeared

FBDS disappeared

FBDS disappeared

Length of stay(days)

13

15

16

12

21

25

17

15

Follow up time(months)

4

4

7

6

6

13

4

4

serum antibody follow up

1:10

–

1:32

–

–

–

–

–

Relapse(months)

No

No

No

1

No

3

No

No

Remaining symptoms

amnesia

amnesia Spatial disorientation

amnesia Insomnia

amnesia

Insomnia

amnesia Spatial disorientation

No

amnesia

AEDs

No

Sodium valproate

Sodium valproate

Sodium valproate

Levetiracetam

Levetiracetam

Sodium valproate

Sodium valproate

Seizure

No

No

No

No

Occasionally(absence seizures)

No

No

No