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8124 Neuropsychiatric features of individuals with LGI1 encephalitis
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8124 Neuropsychiatric features of individuals with LGI1 encephalitis
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Journal Article
8124 Neuropsychiatric features of individuals with LGI1 encephalitis
2025
Overview
LGI1 encephalitis is one of the most common forms of autoimmune encephalitis and has been noted to have prominent psychiatric features. However, psychiatric phenotyping to date has relied on small studies and has lacked detail. This case series aimed to assess psychiatric symptoms and clinical course of patients with a confirmed diagnosis of LGI1 encephalitis identified by our centre. Our sample (n=31) had a mean (SD) age of 61 (14) years, 22/31 (71%) of whom were male. Mean (SD) time to diagnosis was 4.9 (5.8) months and mean follow-up (SD) time was 55.8 (36.7) months. 18/30 patients had documented hyponatraemia, and 22 were managed as inpatients at our centre. Psychiatric (22/31, 71%), cognitive (25/31, 81%) and other neurological (26/31, 84%) symptoms presented at similar rates, despite 30/31 (97%) patients coming from neurology referrals. Patients presented with a diverse range of seizures, including faciobrachial dystonic seizures. Of the 19 patients undergoing detailed psychometric analysis, impairments were noted in memory (19, 100%), executive function (12, 63%) and naming (9, 47%). 13 (42%) patients presented with psychotic symptoms, 12 (39%) with agitation/aggression, 11 (35%) with emotional lability, 8/31 (26%) with anxiety and 5/31 (16%) with cognitive-dysmnesic phenomena. Many patients had psychiatric sequalae which resolved after treatment, but a modest proportion of patients experienced ongoing apathy (2/31, 6%), disinhibition (4/31, 13%), OCD (3/31, 10%), cognitive-dysmnesic phenomena (4/31, 13%) and sleep disorders (9/31, 29%). Our findings show that cognitive impairment and/or psychopathology are rarely absent in LGI1 encephalitis. Future research should examine neuroimaging and EEG correlates of psychiatric and cognitive deficits.
Publisher
BMJ Publishing Group LTD
Subject
