63 year old male presented with new onset faciobrachial dystonic seizures. Imaging showed T2 Flair hyperintensity in left hippocampus. Possibility of autoimmune encephalitis was considered and we went for CSF autoantibody study.Result came as positive for LGI 1 (Leucine rich Glioma Inactivated-1) antibody in CSF.
We also did a paraneoplastic work up to rule out any underlying malignancy. But was unyielding. Patient was treated with steroid pulse with methylprednisolone for 5 days. Subsequently, he was continued on oral steroids. Patient improved. No further seizure episodes. Patient is being kept on follow up.
Final diagnosis
Faciobrachial dystonic seizures
Autoimmune limbic encephalitis
LGI 1 antibody positive
Case Submitted by
Dr Rahul Rajeev, DM Neurology (Std)
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