LGI1 encephalitis–Behaviors predate movements: A case series

Abstract

Anti-leucine-rich, glioma-inactivated (LGI1) autoimmune encephalitis is one of the autoimmune encephalitides with a distinct movement abnormality – faciobrachial dystonic seizures (FBDS). FBDS, being the clinching sign towards a clinical diagnosis, is known to occur at disease onset, and if left untreated, can lead to disabling cognitive impairment. In this case series, we describe three cases of LGI1 encephalitis presenting with behavioral abnormalities at onset for a significant period, compelling an alternative diagnosis preceding the onset of FBDS. In addition, it highlights that imaging could be normal in the initial stages of the disease, further making the diagnosis a challenge at an initial stage.