Amnesia is the second major hallmark of both antibody groups.4 8 11 21 22 Patients often have prominent autobiographical memory loss with marked disorientation and confusion in the acute phase.4 26 By the chronic disease stage, there are typically clear improvements in overall cognitive scores but often a focal memory deficit persists with relative preservation of executive functions, attention, language and visuospatial skills.27 This residual pattern of amnesia likely relates well to both the relatively focal CA3 hippocampal atrophy and the CNS distribution of LGI1.22 27 28. Here, LGI1 is linked to hippocampal atrophy.