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Seizures and memory loss are common features of anti-LGI1 limbic encephalitis,1 a recently described autoimmune encephalitis, previously attributed to voltage-gated potassium channel antibodies (VGKC-ab).2,3
Abnormal involuntary movements are frequently seen in patients diagnosed with anti-LGI1 limbic encephalitis. However, to date it is not clear if these abnormal movements represent seizures or an extrapyramidal movement disorder. Here we describe 3 patients with anti-LGI1 limbic encephalitis, who presented with severe movement abnormalities that were associated with ictal EEG changes.
Methods.
We present 3 female patients (ages 80, 46, and 72) with similar features.
Clinical features.
All patients developed abnormal movements of face, shoulders, arms, or legs (videos 1–3 on the Neurology® Web site at www.neurology.org). These strong, massive movements were slightly slower than typical myoclonus, occurring 5 to 100 times per day. Their consciousness was preserved during the movements.
EEG.
Continuous video-EEG recordings showed that the longer movements were clearly associated with generalized EEG electrodecremental events (EDEs), usually preceding the onset of movement by approximately 500 msec (figure), a pattern typical of epileptic tonic …
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- Tonic seizures: A diagnostic clue of anti-LGI1 encephalitis?
- Tonic seizures: A diagnostic clue of anti-LGI1 encephalitis?
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