LGI1 encephalitis with squamous lung-cell carcinoma: Resolution after tumor resection

Encephalitis with leucine-rich glioma-inactivated-1 (LGI1) immunoglobulin G (IgG) antibodies classically presents with cognitive impairment and characteristic faciobrachial dystonic seizures.1 In a murine model, human LGI1 IgG caused reduction of Kv1.1 channels and α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor receptors resulting in neuronal hyperexcitability indicating probable pathogenicity of LGI1 antibodies.2 LGI1 autoimmunity is associated with malignancy in less than 10% of cases, including small cell lung cancer, prostate and colon cancer, squamous cell skin carcinoma, and neuroendocrine pancreatic cancer.3,4 We present a case of LGI1 encephalitis only partially responsive to immunotherapy with eventual complete resolution after resection of a squamous cell lung carcinoma.

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