Relapsing polychondritis as an unusual cause of multiple cranial nerve palsies A Case report
along with the other symptoms after immunotherapy, suggests involvement of peripheral myelin in anti LGI1 syndromes. Similar conclusions have been obtained experimentally by Silva et al. in mice. We are aware that a single case is not sufficient to demonstrate a cause effect relationship, and that the involvement of peripheral nerves was not the predominant manifestation. We are also aware that our patient was affected by diabetes; however, the improvement of symptoms and NCS parameters after immunotherapy suggests the autoimmune process rather than diabetes as the most probable cause of the polyneuropathy. Nevertheless, our findings should not be overlooked, and NCS studies could be included in the diagnostic protocol of suspected limbic encephalitis both to improve differential diagnosis and to better define the possible role of antiLGI1 and other antibodies as causative agents of peripheral nerve injury.
Muscle nerve