Araki Takeshi, Yoshimura Hajime, Tsuchida Kenta, Hatanaka Noriko, Kawamoto Michi
Department of Neurology, Kobe City Medical Center General Hospital, Japan.
Department of Neurology, Himeji Central Hospital, Japan.
Intern Med. 2025 Apr 15;64(8):1241-1243. doi: 10.2169/internalmedicine.4025-24. Epub 2024 Sep 27.
Anti-leucine-rich glioma-inactivated 1 (LGI1) encephalitis is a treatable form of limbic encephalitis, marked by frequent focal seizures and cognitive decline (particularly memory disturbance); however, it can be difficult to diagnose in patients with subtle cognitive decline. Ictal pouting, a rare seizure feature, has not yet been reported in anti-LGI1 encephalitis. A 73-year-old man with anti-LGI1 encephalitis presented with subacute onset of frequent ictal pouting without apparent cognitive decline. Steroid treatment alone resolved seizures and improved subtle visual memory. Middle-aged and older patients experiencing subacute-onset frequent focal seizures should be thoroughly evaluated for memory disturbances to determine the need for anti-LGI1 antibody measurement.
抗富含亮氨酸胶质瘤失活1（LGI1）脑炎是边缘性脑炎的一种可治疗形式，其特征为频繁的局灶性癫痫发作和认知衰退（尤其是记忆障碍）；然而，对于认知衰退不明显的患者，诊断可能会很困难。口部抽搐是一种罕见的癫痫发作特征，抗LGI1脑炎中尚未有相关报道。一名患有抗LGI1脑炎的73岁男性，以亚急性起病，频繁出现口部抽搐，且无明显认知衰退。仅使用类固醇治疗就使癫痫发作得到缓解，并改善了轻微的视觉记忆。对于亚急性起病、频繁出现局灶性癫痫发作的中老年患者，应全面评估其记忆障碍情况，以确定是否需要检测抗LGI1抗体。
