{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T12:09:13Z","timestamp":1792066153007,"version":"4.4.0"},"reference-count":36,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,7,25]],"date-time":"2017-07-25T00:00:00Z","timestamp":1500940800000},"content-version":"vor","delay-in-days":24,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100007048","name":"Mayo Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007048","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Annals of Neurology"],"published-print":{"date-parts":[[2017,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To describe an expanded phenotypic spectrum and longitudinal outcome in 256 LGI1\u2010IgG\u2013seropositive and\/or CASPR2\u2010IgG\u2013seropositive patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients were identified through service neural autoantibody evaluation. Ninety\u2010five had longitudinal follow\u2010up (7\u2013456 months; median = 35).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 3,910 patients tested, 196 were LGI1\u2010IgG positive, 51 were CASPR2\u2010IgG positive, and 9 were dual positive. Cerebrospinal fluid testing was less sensitive than serum testing, detecting only 24 of 38 (63%) LGI1\u2010IgG\u2013positive and 5 of 6 (83%) CASPR2\u2010IgG\u2013positive patients. LGI1\u2010IgG\u2013positive specimens had higher voltage\u2010gated potassium channel\u2013IgG immunoprecipitation values (0.33nmol\/l, range = 0.02\u20135.14) than CASPR2\u2010IgG\u2013positive specimens (0.10nmol\/l, range = 0.00\u20130.45,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001). Of patients presenting with pain or peripheral nervous system (PNS) manifestations, 39% were LGI1\u2010IgG seropositive (7% had solely neuropathy or pain). Multivariate analysis identified age as the only significant predictor of central nervous system (CNS) versus PNS involvement (&gt;50 years; odds ratio = 15,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001). Paroxysmal dizziness spells (PDS), a unique LGI1\u2010IgG accompaniment (14% of patients), frequently delayed the diagnosis. T2\u2010mesiotemporal hyperintensity was more common in LGI1\u2010IgG\u2013positive (41%) than in CASPR2\u2010IgG\u2013positive patients (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.033). T1\u2010bright basal ganglia were confined to LGI1\u2010IgG\u2013positive patients with faciobrachial\u2013dystonic seizures (9 of 39, 31%). Cancer was found in 44% of LGI1\u2010IgG\/CASPR2\u2010IgG dual seropositive patients (one\u2010third thymoma). Response to initial immunotherapy was favorable in 97%; mean modified Rankin score was 3 (range = 1\u20135) at onset and 1.74 (range = 0\u20136) at last follow\u2010up, with 9% having severe refractory disability, 20% being asymptomatic, 28% receiving immunotherapy, and 58% receiving antiepileptic medication.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>Older age is a strong predictor of CNS involvement in patients seropositive for CASPR2\u2010IgG or LGI1\u2010IgG. Pain, peripheral manifestations, and stereotypic paroxysmal dizziness spells are common with LGI1\u2010IgG. Response to initial immunotherapy is often favorable, but some patients remain severely disabled, requiring long\u2010term immunotherapy and\/or antiepileptic medications. Ann Neurol 2017;82:79\u201392<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ana.24979","type":"journal-article","created":{"date-parts":[[2017,6,19]],"date-time":"2017-06-19T11:32:35Z","timestamp":1497871955000},"page":"79-92","source":"Crossref","is-referenced-by-count":331,"title":["Expanded phenotypes and outcomes among 256\n                    <scp>LGI<\/scp>\n                    1\/\n                    <scp>CASPR<\/scp>\n                    2\u2010\n                    <scp>I<\/scp>\n                    g\n                    <scp>G<\/scp>\n                    \u2013positive patients"],"prefix":"10.1002","volume":"82","author":[{"given":"Avi","family":"Gadoth","sequence":"first","affiliation":[{"name":"Neuroimmunology Laboratory, Department of Neurology Mayo Clinic Rochester MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean J.","family":"Pittock","sequence":"additional","affiliation":[{"name":"Neuroimmunology Laboratory, Department of Neurology 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