Surgical control of limbic encephalitis associated with LGI1 antibodies

Epileptic Disord. 2012 Sep;14(3):345-8. doi: 10.1684/epd.2012.0515.
Almeida V, Pimentel J, Campos A, Bentes C, Maruta C, Morgado C, Martins IP.
Department of Neurosciences, Santa Maria Hospital (CHLN, EPE), Institute of Molecular Medicine, Lisbon Faculty of Medicine.
Limbic encephalitis with LGI1 antibodies may cause drug-resistant temporal lobe epilepsy. We report a case of a young man with progressive drug-resistant focal epilepsy, hyperhidrosis, and memory impairment associated with a left mesial temporal lesion. Epilepsy surgery was performed with the provisional diagnosis of
cortical dysplasia or tumour. A neuropathological study following amygdalohippocampectomy revealed limbic encephalitis and LGI1 antibodies were
identified in the serum. Two and a half years after surgery, the patient remains seizure-free without medication, with normal memory and without hyperhidrosis.
Although immunosuppression is the first-line therapy for autoimmune limbic encephalitis, this case suggests that, in selected cases, a lasting response can be achieved with surgery.