Teaching NeuroImages: 18F-FDG-PET/SPM analysis in 3 different stages from a patient with LGI-1 autoimmune encephalitis
Citation Manager Formats
Make Comment
See Comments

A 50-year-old woman presented with faciobrachial dystonic seizures for about 50 days during sleeping (figure, A). Initial MRI scan was normal, but FDG-PET showed hypermetabolism in the basal ganglia (BG) and medial temporal lobes (MTLs) (figure, B). Clinical symptoms raised a strong suspicion of LGI-1 autoimmune encephalitis (AE) diagnosis, and LGI-1 antibody titer examination (serum and CSF) confirmed the suspicion.1,2 After relapse, the patient showed a previous PET abnormal pattern.
(A) Sequence of events after the patient’s FBDS symptoms appeared. (B) Representative MRI and 18F-FDG-PET/SPM (p < 0.01) image in 3 different time stages from admission diagnosis, relapse, discharge, and review. BG = basal ganglia; IVIg = IV immunoglobulin; IVMP = IV methylprednisolone; MTL = medial temporal lobe; VPA = valproate.
Early diagnosis of LGI-1 AE is necessary for further treatment.2 Abnormal metabolic changes of PET in BG and MTL appeared earlier than in MRI.
Study funding
This work was supported by the National Key R&D Program of China 2017YFC1307500, Beijing-Tianjin-Hebei Cooperative Basic Research Program H2018206435, Capital Healthy Development Research Funding 2016-1-2011, and Beijing Postdoctoral Research Foundation zz 2019-09 (Wei Shan).
Disclosure
The authors report no disclosures relevant to the manuscript. Go to Neurology.org/N for full disclosures.
Appendix Authors

Footnotes
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Teaching slides links.lww.com/WNL/A993
- © 2019 American Academy of Neurology
References
Letters: Rapid online correspondence
REQUIREMENTS
If you are uploading a letter concerning an article:
You must have updated your disclosures within six months: http://submit.neurology.org
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
You May Also be Interested in
Dr. Jeffrey Allen and Dr. Nicholas Purcell
► Watch
Related Articles
Topics Discussed
Alert Me
Recommended articles
-
Article
Evaluation of seizure treatment in anti-LGI1, anti-NMDAR, and anti-GABABR encephalitisMarienke A.A.M. de Bruijn, Agnes van Sonderen, Marleen H. van Coevorden-Hameete et al.Neurology, April 12, 2019 -
Article
Basal ganglia T1 hyperintensity in LGI1-autoantibody faciobrachial dystonic seizuresEoin P. Flanagan, Amy L. Kotsenas, Jeffrey W. Britton et al.Neurology - Neuroimmunology Neuroinflammation, October 01, 2015 -
Clinical/Scientific Notes
Striking basal ganglia imaging abnormalities in LGI1 ab faciobrachial dystonic seizuresA. Sebastian López Chiriboga, Jason L. Siegel, William O. Tatum et al.Neurology: Neuroimmunology & Neuroinflammation, March 14, 2017 -
Article
Leucine-rich glioma-inactivated protein 1 antibody encephalitisA case reportYunis Mayasi, Deepak Takhtani, Neeta Garg et al.Neurology - Neuroimmunology Neuroinflammation, December 11, 2014