Pearls & Oy-sters: Limbic encephalitis associated with positive anti-LGI1 and antithyroid antibodies.

PEARLS Limbic encephalitis is an inflammatory condition of the brain, often characterized by the subacute onset of short-term memory loss, disorientation, seizures, behavioral disturbance, and psychiatric symptoms. Besides paraneoplastic syndromes with onconeural antibodies targeted against intracellular neuronal antigens, limbic encephalitis may also arise from nonparaneoplastic mechanisms with antibodies targeting neuronal cell surface antigens. Antithyroid antibodies can be in coexistence with antibodies to neuronal surface antigens such as leucine-rich glioma inactivated protein 1 (LGI1). IV immunoglobulin (IVIg), plasma exchange, and corticosteroids are all recommended as potential treatment for patients with autoimmune limbic encephalitis with positive anti-LGI1 and antithyroid antibodies.