Clinical Characteristics and Prognostic Analysis of Anti-LGI 1 Receptor Encephalitis in Northeast China
Authors: Zhao Qian , Li Mengmeng , lu yingxue , Lin Weihong 
Published: July 2020

Abstract
Background: To investigate the clinical characteristics and prognosis of Anti-LGI1 receptor encephalitis.Methods: This retrospective study enrolled forty -one patients with anti LGI1 receptor encephalitis diagnosed for the first time in the Department of Neurology, the first hospital of Jilin University from June 2015 to November 2019. Results: There are twenty-two males and nineteen females, with a median age of fifty-four years. The first symptom of male patients showed cognitive impairment in nine (40.91%) cases,facial muscle dystonia in six (27.27%) cases.Of the female patients,seven (36.84%)patients had facial-arm dystonia-like seizures,six (31.58%) patients had cognitive impairment.seven (18.42%) patients had abnormal tumor markers,but no tumor was found in all patients.Thirty patients (73.17%) had hyponatremia with a minimum of 115.4 mmol/L.Except for one patient,eighteen (45.00%) patients had normal cerebrospinal fluid indicators,twenty-two (55.00%) patients had abnormal cerebrospinal fluid indicators,Eleventh (50.00%) patients had elevated protein,and nine (40.91%) patients had elevated IgG,six (27.27%) patientys of white blood cells increased,and four (18.18%) patients of increased pressure. Except for four patients,twenty-two (59.46%) patients had abnormal signals of hippocampus and temporal lobe,seventeen (77.27%) of them had bilateral abnormal signals of hippocampus,five(22.73%)cases had unilateral abnormal signals of hippocampus;Eleventh(29.73%)had lacunar Cerebral infarction and ischemic focus;Two(5.41%)cases of frontal and insular abnormal signals;one(2.70%)case of temporal and occipital abnormal signals;one(2.70%) case of white matter lesions. Except for one patient,the EEG showed twenty-seven(67.50%)cases of slow waves and focal discharges,(six(22.22%) of which were left-temporal spiked slow waves,and five (18.52%) were of right-temporal spikes Slow wave,four (14.81%) cases with double temporal sharpened slow wave,six (22.22%) cases with frontotemporal sharpened slow wave, one (3.70%) case with frontal sharpened slow wave,one(3.70%)case with Three-phase waves; In addition,four(10.00%)cases of fast activity increased;three (7.50%) cases of background α generalization). Patients received first-line immunotherapy except six patients who gave up treatment. Conclusions: Anti-LGI1 receptor encephalitis is more common in middle-aged and older people. In male,the first manifestation is cognitive impairment, and the female is more common with the facial-arm dystonia-like seizures,and rarely can be manifested as discharge sensation, hallucinations and autonomic symptoms.lumbar puncture pressure increased more than decreased;protein was significantly higher than leukocytes;EEG showed slow waves and focal discharges were more common, and abnormal background and normal EEG can occur.MRI shows that hippocampus and temporal lobe abnormal signal have the highest proportion.There is no significant difference in the prognosis of hormones, globulin,or both.