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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2016; 74(11): 947
DOI: 10.1590/0004-282X20160146
IMAGES IN NEUROLOGY

Imaging findings in faciobrachial dystonic seizures associated with LGI-1 antibodies

Achados de imagem em crises distçnicas braquiofaciais associadas à anticorpos anti-LGI-1
Ronnyson Susano Grativvol
1   Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Neurologia, São Paulo SP, Brasil;
,
Mateus Mistieri Simabukuro
1   Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Neurologia, São Paulo SP, Brasil;
,
Raphael Ribeiro Spera
1   Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Neurologia, São Paulo SP, Brasil;
,
Wagner Cid Palmeira Cavalcante
1   Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Neurologia, São Paulo SP, Brasil;
,
Hugo Henrique Soares Araújo
1   Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Neurologia, São Paulo SP, Brasil;
,
Daniel Sakuno
2   Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Instituto de Radiologia, São Paulo SP, Brasil.
,
Leandro Tavares Lucato
2   Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Instituto de Radiologia, São Paulo SP, Brasil.
,
Lécio Figueira Pinto
1   Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Neurologia, São Paulo SP, Brasil;
,
Luiz Henrique Martins Castro
1   Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Neurologia, São Paulo SP, Brasil;
,
Ricardo Nitrini
1   Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Departamento de Neurologia, São Paulo SP, Brasil;
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A 76-year-old woman presented with a three-month history of faciobrachial dystonic seizures associated with cognitive impairment and hyponatremia. Cerebrospinal fluid analysis was unremarkable. A whole-body CT scan demonstrated no malignancies. Brain MRI revealed involvement of the mesial right temporal lobe, right striatum and globus pallidus and bilateral supratentorial white matter ([Figures A, B, C]). Leucine-rich glioma inactivated protein 1 (LGI-1) antibodies were detected in the serum. The patient received immunosuppressive treatment, with a partial response. LGI-1 encephalitis is an immune-mediated encephalitis characterized by cognitive impairment associated with faciobrachial dystonic seizures and hyponatremia[1]. Neuroimaging findings include mesial temporal lobes, basal ganglia and supratentorial white matter abnormalites[2],[3].

Zoom Image
Figure Fluid-attenuated inversion recovery (FLAIR) images (A-C) disclosed increased signal in the right caudate and putamen (arrow in A); right hippocampus and amygdala (arrow in B); and slight blurring of the bilateral supratentorial white matter (arrows in C). A small remote vascular injury in the right occipital pole was also noticed, but considered unrelated to the case (images A-B).

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Conflict of interest:

There is no conflict of interest to declare.

  • References

  • 1 Lancaster E, Martinez-Hernandez E, Dalmau J. Encephalitis and antibodies to synaptic and neuronal cell surface proteins. Neurology. 2011;77(2):179-89. doi:10.1212/WNL.0b013e318224afde
  • 2 Plantone D, Renna R, Grossi D, Plantone F, Iorio R. Teaching neuroimages: basal ganglial involvement in facio-brachial dystonic seizures associated with LGI1 antibodies. Neurology. 2013;80(17):e183-184. doi:10.1212/WNL.0b013e31828f17fa
  • 3 Urbach H, Rauer S, Mader I, Paus S, Wagner J, Malter MP et al. Supratentorial white matter blurring associated with voltage-gated potassium channel-complex limbic encephalitis. Neuroradiology. 2015;57(12):1203-9. doi:10.1007/s00234-015-1581-x

Address for correspondence

Ronnyson Susano Grativvol
HCFMUSP; Departamento de Neurologia; Av. Dr. Enéas de Carvalho Aguiar, 255 / 5° andar; 05403-001, São Paulo SP
Brasil   

Publikationsverlauf

Eingereicht: 19. Juli 2016

Angenommen: 10. August 2016

Artikel online veröffentlicht:
06. September 2023

© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Lancaster E, Martinez-Hernandez E, Dalmau J. Encephalitis and antibodies to synaptic and neuronal cell surface proteins. Neurology. 2011;77(2):179-89. doi:10.1212/WNL.0b013e318224afde
  • 2 Plantone D, Renna R, Grossi D, Plantone F, Iorio R. Teaching neuroimages: basal ganglial involvement in facio-brachial dystonic seizures associated with LGI1 antibodies. Neurology. 2013;80(17):e183-184. doi:10.1212/WNL.0b013e31828f17fa
  • 3 Urbach H, Rauer S, Mader I, Paus S, Wagner J, Malter MP et al. Supratentorial white matter blurring associated with voltage-gated potassium channel-complex limbic encephalitis. Neuroradiology. 2015;57(12):1203-9. doi:10.1007/s00234-015-1581-x

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Zoom Image
Figure Fluid-attenuated inversion recovery (FLAIR) images (A-C) disclosed increased signal in the right caudate and putamen (arrow in A); right hippocampus and amygdala (arrow in B); and slight blurring of the bilateral supratentorial white matter (arrows in C). A small remote vascular injury in the right occipital pole was also noticed, but considered unrelated to the case (images A-B).