title: [Unexplicated neuropsychiatric disorders: Do not ignore dysimmune encephalitis. A case report of a dysimmune encephalitis with anti-leucine rich glioma inactivated 1 (LGI-1) antibodies].
abstract: BACKGROUND
  Anti-leucine rich glioma inactivated 1 encephalitis is a common and a treatable etiology of autoimmune encephalitis. Its diagnosis is a challenge because the initial diagnostic work-up is often normal.
  
  
  METHODS
  A 48-year-old man experienced cognitive and behavioral troubles, facio-brachial dystonic seizures and a syndrome of inappropriate antidiuretic hormone secretion. First line tests excluded infectious, neoplastic, systemic inflammatory, endrocrine or toxic etiologies. Cerebral (18)Fluoro-desoxy-glucose (FDG) position emission tomography and research of specific antibodies in cerebro-spinal fluid and serum led to diagnose an anti-leucine rich glioma inactivated 1 encephalitis. Intravenous immunoglobulins and corticosteroids were partially effective. Cyclophosphamid permitted a good recovery.
  
  
  CONCLUSIONS
  In the presence of acute neuropsychiatric disorders with a negative etiologic research, physician should think about dysimmune encephalitis. Facio-brachial dystonic seizures and syndrome of inappropriate antidiuretic hormone secretion are highly evocative of anti-leucine rich glioma inactivated 1 encephalitis. The diagnosis needs specific diagnostic tests (cerebral (18)FDG position emission tomography and antibodies research in cerebro-spinal fluid and in serum), after the exclusion of alternative diagnoses. Extensive and repeated diagnostic work-up for neoplasia is required. Immunosupressive therapies are effective in most cases.
authors.affiliation: Service de pathologie infectieuse et tropicale, hôpital d'instruction des armées Laveran, 34, boulevard Alphonse-Laveran, 13014 Marseille, France. Electronic address: erwan.le.dault@gmail.com.
authors.forename: E
authors.initials: E
authors.lastname: Le Dault
authors.affiliation: Service de neurologie, hôpital d'instruction des armées Laveran, 34, boulevard Alphonse-Laveran, 13014 Marseille, France.
authors.forename: S
authors.initials: S
authors.lastname: Lagarde
authors.affiliation: Service de médecine nucléaire, CHU La Timone, AP-HM, 264, rue Saint-Pierre, 13385 Marseille, France.
authors.forename: E
authors.initials: E
authors.lastname: Guedj
authors.affiliation: Service de neurologie, CHU La Timone, AP-HM, 264, rue Saint-Pierre, 13385 Marseille, France.
authors.forename: B
authors.initials: B
authors.lastname: Dufournet
authors.affiliation: Service de neurologie, CHU La Timone, AP-HM, 264, rue Saint-Pierre, 13385 Marseille, France.
authors.forename: C
authors.initials: C
authors.lastname: Rey
authors.affiliation: Service de neurologie, CHU La Timone, AP-HM, 264, rue Saint-Pierre, 13385 Marseille, France.
authors.forename: E
authors.initials: E
authors.lastname: Kaphan
authors.affiliation: Service de neurologie, hôpital d'instruction des armées Laveran, 34, boulevard Alphonse-Laveran, 13014 Marseille, France.
authors.forename: G
authors.initials: G
authors.lastname: Tanguy
authors.affiliation: Service de neurologie, hôpital d'instruction des armées Laveran, 34, boulevard Alphonse-Laveran, 13014 Marseille, France.
authors.forename: M
authors.initials: M
authors.lastname: Bregigeon
authors.affiliation: Service de neurologie, hôpital d'instruction des armées Laveran, 34, boulevard Alphonse-Laveran, 13014 Marseille, France.
authors.forename: E
authors.initials: E
authors.lastname: Sagui
authors.affiliation: Service de neurologie, hôpital d'instruction des armées Laveran, 34, boulevard Alphonse-Laveran, 13014 Marseille, France.
authors.forename: C
authors.initials: C
authors.lastname: Brosset
mesh_terms: D001323:Autoantibodies / Q000276:immunology*; D004660:Encephalitis / Q000150:complications / Q000175:diagnosis* / Q000276:immunology*; D050031:Hashimoto Disease / Q000150:complications / Q000175:diagnosis* / Q000276:immunology*; D006801:Humans; D047908:Intracellular Signaling Peptides and Proteins; D008297:Male; D001523:Mental Disorders / Q000209:etiology; D008875:Middle Aged; D011506:Proteins / Q000276:immunology*
chemical_list: D001323:Autoantibodies; D047908:Intracellular Signaling Peptides and Proteins; C116499:LGI1 protein, human; D011506:Proteins
keywords: Autoimmune encephalitis; Dysimmune encephalitis; Encéphalite auto-immune; Encéphalite dysimmunitaire; Facio-brachial dystonic seizures; Leucine rich glioma inactivated 1 (LGI-1); Spasmes brachio-faciaux; Voltage gate potassium channel (VGKC)