[Autoimmune Associated Encephalitis and Dementia]

Brain Nerve. 2016 Apr;68(4):341-50. doi: 10.11477/mf.1416200403.
[Article in Japanese]

Abstract

Antibodies against various neural surface antigens induce cognitive impairments. Anti-VGKC (voltage gated potassium channel) complex antibodies are well known as one of the causative autoantibodies. An anti-VGKC antibody was identified as the autoantibody in acquired neuromyotonia (Isaacs' syndrome), which causes muscle cramps and difficulty in opening the palm of the hands. However, this antibody also tests positive in autoimmune limbic encephalitis, which has a subacute progress and causes poor memory or epilepsy attacks. Typical cases have a distinctive adult-onset, frequent, brief dystonic seizure semiology that predominantly affects the arms and ipsilateral face. It has now been termed faciobrachial dystonic seizures. In recent years, the true target antigens of the anti-VGKC antibody of this VGKC limbic encephalitis have been recognized as leucine rich glioma inactivated protein (LGI)-1 and others. These antibodies to amnesia-related LGI-1 in limbic encephalitis neutralize the LGI-1-ADAM22 (an anchor protein) interaction and reduce synaptic AMPA receptors. There have been reports of limbic encephalitis associated with anti-VGKC complex antibodies mimicking Creutzfeldt-Jakob disease (CJD). Less than 2% of the patients with sporadic CJD (sCJD) develop serum anti-VGKC complex antibodies and, when positive, only at low titres. Low titres of these antibodies occur only rarely in suspected patients with sCJD, and when present, should be interpreted with caution.

Publication types

  • English Abstract
  • Review

MeSH terms

  • Animals
  • Autoantibodies / metabolism*
  • Autoimmune Diseases / complications
  • Autoimmune Diseases / diagnosis
  • Autoimmune Diseases / immunology*
  • Autoimmune Diseases / therapy
  • Cognition Disorders / complications
  • Cognition Disorders / diagnosis
  • Cognition Disorders / immunology*
  • Cognition Disorders / therapy
  • Creutzfeldt-Jakob Syndrome / complications
  • Creutzfeldt-Jakob Syndrome / diagnosis
  • Creutzfeldt-Jakob Syndrome / immunology*
  • Creutzfeldt-Jakob Syndrome / therapy
  • Humans
  • Limbic Encephalitis / complications
  • Limbic Encephalitis / diagnosis
  • Limbic Encephalitis / immunology*
  • Limbic Encephalitis / therapy
  • Potassium Channels, Voltage-Gated / immunology*

Substances

  • Autoantibodies
  • Potassium Channels, Voltage-Gated

Supplementary concepts

  • Autoimmune limbic encephalitis