Severe bradycardia requiring pacemaker insertion is recognised with LGI1 antibodies, tending to predate limbic encephalitis and likely relating to insular or temporal lobe epileptic activity.33 Also, asystole, QT-interval prolongation, bradycardia and sudden cardiac death are all recognised in connection with CASPR2 antibodies, particularly in patients with Morvan’s syndrome.8 13 Autonomic dysfunction can also manifest with hyperhidrosis, diarrhoea, urinary dysfunction, hypertension and hypotension.13 This evidence concerns the gene LGI1 and Morvan syndrome.