ORIGINAL RESEARCH article
Front. Neurol.
Sec. Multiple Sclerosis and Neuroimmunology
Anti-LGI1 Encephalitis: Clinical Presentation, Imaging Profiles, and Prognostic Indicators
Provisionally accepted
- 1Xinxiang Medical University, Xinxiang, China
- 2Henan Provincial People's Hospital, Zhengzhou, China
- 3Henan Provincial People's Hospital Department of Neurology, Zhengzhou, China
- 4Zhengzhou University, Zhengzhou, China
- 5Henan University, Kaifeng, China
- 6Peking Union Medical College Hospital, Beijing, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Objective: To investigate the clinical features, neuroimaging characteristics, and prognosis of patients with anti–leucine-rich glioma-inactivated 1 (LGI1) antibody associated encephalitis. Methods: We conducted a retrospective study of 87 patients diagnosed with anti-LGI1 encephalitis during the acute phase, admitted to two tertiary hospitals in China between January 2022 and September 2024. Clinical data, neuroimaging findings, and follow-up outcomes were systematically analyzed. Results: The primary clinical manifestations included memory impairment, epileptic seizures, psychiatric and behavioral disturbances, sleep dysfunction, involuntary movements, faciobrachial dystonic seizures (FBDS), and autonomic dysfunction. Among 53 patients tested for thyroid function, 9 (17.0%) exhibited abnormalities. Hyponatremia was observed in 41 of 82 patients (50.0%), and hyperhomocysteinemia (HHCY) in 23 of 80 (28.7%). Among 68 patients who underwent cerebrospinal fluid (CSF) analysis, elevated intracranial pressure was observed in 10 (14.7%), pleocytosis in 22 (32.4%), and elevated protein levels in 27 (39.7%). Electrocardiographic abnormalities were identified in 26 of 42 patients (61.9%) without prior cardiovascular disease. MRI abnormalities were present in 75 of 80 patients (93.8%), most commonly affecting the temporal lobe (55.0%), hippocampus (51.2%), and amygdala (11.2%). PET imaging in 39 patients frequently revealed hypermetabolism in the basal ganglia and temporal lobe. All patients received first-line immunotherapy. Of the 63 patients with follow-up data, 59 (93.7%) achieved favorable outcomes. Conclusion: Anti-LGI1 encephalitis is an immune-mediated autoimmune disorder characterized by memory impairment, epileptic seizures, FBDS, psychiatric and behavioral disturbances, autonomic dysfunction, hyponatremia, and HHCY. Immunotherapy is generally effective, leading to favorable prognosis in the majority of patients.
Keywords: autoimmune encephalitis, anti-leucine-rich glioma-inactivated 1 antibody, Encephalitis, Immunotherapy, prognosis
Received: 11 Sep 2025; Accepted: 11 Nov 2025.
Copyright: © 2025 Chen, Liu, Wang, Lu, 左, Zheng, Guan and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Hongzhi Guan, pumchghz@126.com
Wei Li, liwei71@126.com
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.