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J Neuroimmunol. 2018 Apr 15;317:8-14. doi: 10.1016/j.jneuroim.2018.02.005. Epub 2018 Feb 7.

Psychiatric symptoms delay the diagnosis of anti-LGI1 encephalitis.

Author information

1
Department of Neurology, Seoul National University Hospital, Seoul, South Korea; Program in Neuroscience, Neuroscience Research Institute of SNUMRC, College of Medicine, Seoul National University, Seoul, South Korea.
2
Department of Neurology, Seoul National University Hospital, Seoul, South Korea; Department of Neurology, National Center for Mental Health, an Affiliate of the Ministry for Health and Welfare, Seoul, South Korea.
3
Department of Neurology, Soonchunhyang University Seoul Hospital, Seoul, South Korea.
4
Department of Neurology, Seoul National University Hospital, Seoul, South Korea; Program in Neuroscience, Neuroscience Research Institute of SNUMRC, College of Medicine, Seoul National University, Seoul, South Korea; Department of Neurology, Seoul National University Healthcare System Gangnam Center, Seoul, South Korea.
5
Department of Neurology, Seoul National University Hospital, Seoul, South Korea; Program in Neuroscience, Neuroscience Research Institute of SNUMRC, College of Medicine, Seoul National University, Seoul, South Korea. Electronic address: sangkun2923@gmail.com.
6
Department of Neurology, Seoul National University Hospital, Seoul, South Korea; Program in Neuroscience, Neuroscience Research Institute of SNUMRC, College of Medicine, Seoul National University, Seoul, South Korea. Electronic address: stemcell.snu@gmail.com.

Abstract

The aim of this study was to analyze the detailed characteristics of the psychiatric symptoms in patients with anti-LGI1 encephalitis. Of 16 patients, ten showed psychiatric symptoms as the initial manifestations. All 10 patients experienced mood-related symptoms. The time to immune therapy was longer in those with initial psychiatric symptoms compared to those without them. Initial manifestation of psychiatric symptoms in patients with anti-LGI1 encephalitis may be a poor prognostic factor, at least in the short term, in that it misleads both the patients and the clinicians to neglect the typically accompanied symptoms of the disease such as faciobrachial dystonic seizure, delaying the timing of immune therapy.

KEYWORDS:

Anti-LGI1 encephalitis; Dementia; Epilepsy-related psychosis; Prognostic factor; Psychiatric symptom; Senile depression

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