Orbitofrontal syndrome and “goosebumps”—A new manifestation of autoimmune epilepsy in anti-LGI1 encephalitis

Anti–leucine-rich glioma-inactivated 1 (anti-LGI1) encephalitis is a rare autoimmune disorder that presents with a triad of cognitive and psychiatric disturbances, hyponatremia, and autoimmune epilepsy. Facial-brachial dystonic (FBD) seizures are considered a pathognomonic sign of this condition. However, more subtle seizure types can occur and should be recognized, allowing for timely diagnosis and treatment. We report a case of anti-LGI1 autoimmune encephalitis presenting as orbitofrontal syndrome with focal “goosebump” seizures.