Furthermore, the distinction between symptomatic seizures in the context of a relapse and autoimmune encephalitis–associated epilepsy19 must be carefully evaluated because few patients with LGI1-Ab encephalitis develop epilepsy in the long-term.8,20 In addition, infections and changes in lifestyle or medications can worsen cognition in older predisposed patients. The gene discussed is LGI1; the disease is encephalitis.