B - 111 The Role of Education, and Advocacy in Repeat Neuropsychological Evaluations of a Spanish Speaking Woman with Anti-LG-1 Encephalitis.

Abstract

Anti-leucine-rich glioma-inactivated 1 limbic encephalitis (LGI1-LE) is a rare diagnosis but the second most common autoimmune encephalitis. While it has a growing body of neuropsychological literature, there is limited awareness by the lay public about this condition. As with all complex neurological conditions, caregiver/family understanding of the disorder and engagement in treatment is important for optimal recovery and dyad wellbeing. We present the case of a caregiver and patient dyad with confirmed LGI1-LE/ Voltage-Gated Potassium Channel antibodies seen for repeat neuropsychological evaluations to demonstrate the importance of education, advocacy, and multidisciplinary involvement as part of the neuropsychological assessment process. Repeat neuropsychological evaluations of a 72-year-old Spanish-speaking woman with limited formal education and complex medical history, including past strokes and recent autoimmune encephalitis. Initial evaluation revealed marked behavioral and cognitive fluctuations/variability with familial frustration secondary to poor understanding by caregiver until neuropsychological feedback session. Repeat evaluation was delayed four weeks due to caregiver factors but demonstrated improvement in global cognition and overall functioning. Follow up, six months later, demonstrated significant cognitive decline and new motoric symptoms with further difficulty coordinating appointments by the caregiver. In addition to assistance with medical management, neuropsychological involvement led to connection to case management, home evaluation, concrete solutions for food insecurity, and cognitive evaluation for the caregiver. This case adds to LG1-LE literature and demonstrates the importance of neuropsychology not only for disease tracking/ management but also as an important tool for advocacy and patient/caregiver education, specifically in culturally and educationally diverse populations with complex medical conditions.