Faciobrachial dystonic seizures in an Lgi1 VGKC-complex antibody-mediated encephalitis
Bibliographic record
Abstract
A 71-year-old woman presented with a 6-week history of progressive involuntary right face and arm jerking movements associated with prominent memory loss and frequent falls. She subsequently developed similar movements involving her left face and arm. Montreal Cognitive Assessment (MoCA) score was 19/30 and physical examination was otherwise normal. There was no alteration of consciousness. A video EEG recorded bilateral clinical activity with no alteration in consciousness and no electrographic epileptiform correlate (see video at [Neurology.org/cp][1]). MRI demonstrated nonenhancing diffuse T2 hyperintensity of the hippocampal region of the left medial temporal lobe (figure). Serum and CSF were positive for voltage-gated potassium channel (VGKC) antibodies (6,534 pmol/L and 160 pmol/L, respectively). Anti-Lgi1 antibodies were strongly positive, and anti-Caspr2 antibodies were negative. Onconeuronal antibodies and paraneoplastic workup were negative; serum sodium nadir was 130 mmol/L, coinciding with cognitive nadir. She received pulsed methylprednisolone and IV immunoglobulin and responded rapidly, with involuntary movements abolished within 2 weeks. Memory improved over 2 months and function returned to baseline, although amnesia for the period of illness and retrograde amnesia extending 2 months prior persists. Her MoCA score plateaued at 27/30. IV immunoglobulin was discontinued after 2 months, and the steroid taper continues gradually. Follow-up MRI at 4 months demonstrated resolution of the left hippocampal T2 hyperintensity. [1]: http://cp.neurology.org/lookup/doi/10.1212/CPJ.0000000000000168
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.002 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".