Incident anti-LGI1 autoimmune encephalitis during dementia with Lewy bodies: when Occam razor is a double-edged sword

Denise Cerne; Mattia Losa; Pietro Mattioli; Anastasia Lechiara; Giacomo Rebella; Luca Roccatagliata; Dario Arnaldi; Angelo Schenone; Silvia Morbelli; Luana Benedetti; Federico Massa

doi:10.1016/j.jneuroim.2024.578291

Incident anti-LGI1 autoimmune encephalitis during dementia with Lewy bodies: when Occam razor is a double-edged sword

J Neuroimmunol. 2024 Feb 15:387:578291. doi: 10.1016/j.jneuroim.2024.578291. Epub 2024 Jan 14.

Authors

Affiliations

¹ Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy.
² Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
³ Autoimmunity Laboratory, IRCCS Ospedale Policlinico San Martino, Genova, Italy.
⁴ Department of Neuroradiology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy; Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.
⁵ IRCCS Ospedale Policlinico San Martino, Genoa, Italy; Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.
⁶ Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy. Electronic address: fedemassa88@gmail.com.

PMID: 38237526
DOI: 10.1016/j.jneuroim.2024.578291

Abstract

In Dementia with Lewy bodies (DLB), rapid cognitive decline and seizures seldom complicate the typical clinical course. Nevertheless, concurrent, treatable conditions may be responsible. We report a case of DLB with superimposed anti-LGI1 encephalitis, emphasizing the importance of thorough diagnostic reasoning beyond the simplest explanation amid distinct clinical cues.

Keywords: Anti-LGI1; Autoimmune encephalitis; Dementia with Lewy body; EEG.

Publication types

Case Reports
Research Support, Non-U.S. Gov't

MeSH terms

Autoimmune Diseases of the Nervous System*
Dementia* / diagnosis
Encephalitis* / complications
Hashimoto Disease*
Humans
Lewy Body Disease* / diagnosis

Supplementary concepts

Hashimoto's encephalitis