LGI1 and encephalitis: While auditory involvement is not typically recognized as a common manifestation in LGI-1 encephalitis, this patient's progressive bilateral high-frequency SNHL, in the absence of other identifiable otologic etiologies, suggests a potential autoimmune mechanism involving bilateral cochlear and/or peripheral retro-cochlear pathways, consistent with LGI-1 expression in both central and peripheral auditory synaptic regions [3].