Anti LG1 VGCK autoimmune encephalitis: management
Written and reviewed by Dr Ibrahim Imam, Consultant Neurologist. Last reviewed .
Anti LG1 VGCK autoimmune encephalitis: management. This shows hippocampal T2 hyperintensities in 75% of cases. Fully referenced neurology checklist.
Magnetic resonance imaging (MRI)
- This shows hippocampal T2 hyperintensities in 75% of cases
- These often evolve into mesial temporal sclerosis
- Lesions also seen in the basal ganglia
Positron emission tomography (PET) scan
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Anti VGKC antibody test
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Serum neurofilament light (NfL)
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Cerebrospinal fluid (CSF) analysis
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Initial treatment: steroids
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Initial treatment: others
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Secondary treatment for refractory cases
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References
- Lee R, Buckley C, Irani SR, Vincent A. Autoantibody testing in encephalopathies. Pract Neurol 2012; 12:4-13.
- Vincent A, Bien CG, Irani SR, Waters P. Autoantibodies associated with diseases of the CNS: new developments and future challenges. Lancet Neurol 2011; 10:759-772.
- Thieben MJ, Lennon VA, Boeve BF, Aksamit AJ, Keegan M, Vernino S. Potentially reversible autoimmune limbic encephalitis with neuronal potassium channel antibody. Neurology 2004; 62:1177-1182.
- Flanagan EP, Kotsenas AL, Britton JW, et al. Basal ganglia T1 hyperintensity in LGI1-autoantibody faciobrachial dystonic seizures. Neurol Neuroimmunol Neuroinflamm 2015; 2:e161.
- Kim YE, Lim JS, Lee Y, Lee JH. Teaching NeuroImage: Glucose hypermetabolism in the basal ganglia: the decisive clue to the diagnosis of an unusual anti-LGI1 Encephalitis. Neurology 2023; 101:90-91.
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