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NBA Player Langston Galloway’s ETHICS Shoe Brand Launches The lgONE

Sneaker News

January 19, 2022

This post contains references to products from one or more of our advertisers. We may receive compensation when you click on links to those products. The opinions and information provided on this site are original editorial content of Sneaker News.

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Sneaker fanatics have always kept a keen eye on the hardwood to see which NBA players were bringing the proverbial “it” to the conversation. Langston Galloway has steadily flexed his sneaker know-how and underrated collection for years, but he set a new standard by unveiling his own sneaker brand (yes, his own brand) during the 2021 NBA Finals.

The ETHICS shoe brand, co-founded with his wife Monica, was the result of an arduous process that began with his enrolling in the Harvard Business School and NBA’s joint program “Crossover into Business”. After working closely with his footwear designer Brett Golliff (an design industry vet who worked at New Balance and has been at General Motors for over a decade), various rounds of product sampling with manufacturers, Langston arrived at the lgONE, the first-ever launch for ETHICS.

What truly separates the lgONE from products from industry giants is that the shoe is entirely hand-stitched. This type of cut-and-sew manufacturing is simply unfounded in the current landscape due to mass production practices. Langston himself has been playing and testing the shoe for a year, so to put it simply, they’re NBA ready.

The ETHICS lgONE is available now for $120 directly from the ETHICS online shop. Five more colorways of the lgONE are set to launch this year, and the lgTWO is currently in development.

Ethics LG1 Shoes: A Comprehensive Guide to Sustainable Footwear - Monusco

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Joan Sparks

May 4, 2023

Ethics LG1 Shoes: A Comprehensive Guide to Sustainable Footwear

When it comes to choosing the right shoes, not only do we look for style and comfort, but also ethical manufacturing practices and sustainable materials. Ethics LG1 Shoes, with their commitment to sustainability and ethical production, have emerged as a leading brand in the footwear industry. In this blog article, we will delve into the world of Ethics LG1 Shoes, exploring their unique features, manufacturing processes, and the positive impact they have on the environment and society.

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The History of Ethics LG1 Shoes: From Humble Beginnings to Sustainable SuccessPioneers in Sustainable FootwearTransparency and AccountabilityRecognition and AwardsSustainable Materials Used in Ethics LG1 ShoesRecycled PlasticOrganic CottonVegan Leather AlternativesNatural RubberEthical Manufacturing ProcessesFair Wages and Working ConditionsResponsible SourcingWaste Reduction and RecyclingWater ConservationThe Comfort and Durability of Ethics LG1 ShoesInnovative TechnologiesQuality CraftsmanshipVersatile DesignsEthics LG1 Shoes and Social ResponsibilityPartnerships with Non-Profit OrganizationsCommunity Outreach ProgramsEmployee VolunteerismCustomer Reviews and TestimonialsUnparalleled ComfortDurability that LastsStyle Meets SustainabilityEthics LG1 Shoes: A Style StatementElevate Your WardrobeVersatile and FunctionalAttention to DetailHow Ethics LG1 Shoes Compare to Other Sustainable Footwear BrandsPremium Quality at an Affordable PriceInnovative Design and FunctionalityTransparency and AccountabilityFrequently Asked Questions about Ethics LG1 ShoesWhat sizes are available for Ethics LG1 Shoes?How do I care for my Ethics LG1 Shoes?Do Ethics LG1 Shoes come with a warranty?Are Ethics LG1 Shoes suitable for people with wide feet?Are Ethics LG1 Shoes suitable for vegans?Where to Buy Ethics LG1 ShoesOfficial WebsiteAuthorized RetailersSpecial Offers and DiscountsRelated video of Ethics LG1 Shoes: A Comprehensive Guide to Sustainable Footwear

The History of Ethics LG1 Shoes: From Humble Beginnings to Sustainable Success

Every successful brand has a story, and Ethics LG1 Shoes is no exception. Founded with a vision to redefine the footwear industry, the brand started as a small initiative by a group of passionate individuals dedicated to making a difference. Over the years, Ethics LG1 Shoes has grown from its humble beginnings to become a trailblazer in sustainable footwear. Their commitment to sustainability and ethical practices has earned them a loyal customer base and recognition as a leader in the industry.

Pioneers in Sustainable Footwear

From the outset, Ethics LG1 Shoes set out to revolutionize the way shoes are made. They recognized the environmental impact of traditional manufacturing processes and aimed to create a more sustainable alternative. By incorporating recycled materials, organic fabrics, and innovative manufacturing techniques, Ethics LG1 Shoes quickly established itself as a pioneer in sustainable footwear.

Transparency and Accountability

Ethics LG1 Shoes believes in transparency and accountability. They are committed to being open about their supply chain, manufacturing processes, and the materials used in their shoes. Through this transparency, they aim to empower consumers to make informed choices and contribute to a more sustainable future.

Recognition and Awards

The dedication of Ethics LG1 Shoes to sustainability and ethical practices has been widely recognized. They have received numerous awards and accolades for their commitment to creating environmentally friendly footwear without compromising on style and quality. These accolades serve as a testament to the brand’s unwavering dedication to making a positive impact.

Sustainable Materials Used in Ethics LG1 Shoes

One of the key pillars of Ethics LG1 Shoes is their use of sustainable materials. By carefully selecting eco-friendly alternatives to traditional shoe materials, they minimize their environmental footprint while still creating stylish and durable shoes.

Recycled Plastic

Ethics LG1 Shoes understands the impact of plastic waste on the environment. To combat this issue, they incorporate recycled plastic materials into their shoe production. By repurposing plastic waste, they not only reduce the demand for new plastic but also contribute to cleaner oceans and a healthier planet.

Organic Cotton

Cotton is a widely used material in the fashion industry, but conventional cotton farming practices can have a detrimental impact on the environment. Ethics LG1 Shoes recognizes this and opts for organic cotton in their shoe manufacturing. Organic cotton is grown without the use of harmful pesticides and chemicals, making it a more sustainable and eco-friendly choice.

Vegan Leather Alternatives

Leather production is associated with deforestation, water pollution, and animal cruelty. Ethics LG1 Shoes offers vegan leather alternatives, which are made from plant-based or synthetic materials that mimic the look and feel of real leather without harming animals or the environment. These alternatives are not only cruelty-free but also more sustainable.

Natural Rubber

Ethics LG1 Shoes utilizes natural rubber in their shoe soles, which is a renewable resource. Natural rubber is derived from the sap of rubber trees, and its extraction does not harm the trees. By using natural rubber, Ethics LG1 Shoes reduces their reliance on petroleum-based synthetic rubbers, which have a higher environmental impact.

Ethical Manufacturing Processes

At Ethics LG1 Shoes, ethical manufacturing practices are at the core of their operations. They strive to create a positive impact on the workers, communities, and the planet through responsible manufacturing processes.

Fair Wages and Working Conditions

Ethics LG1 Shoes believes in providing fair wages and safe working conditions for all individuals involved in the manufacturing process. They ensure that their workers are treated with dignity and respect, and that their rights are protected. By supporting fair wages and working conditions, Ethics LG1 Shoes promotes a more equitable and just society.

Responsible Sourcing

Ethics LG1 Shoes takes great care in sourcing materials responsibly. They work closely with suppliers who share their commitment to sustainability and ethical practices. By prioritizing responsible sourcing, they minimize the environmental impact associated with the extraction and production of raw materials.

Waste Reduction and Recycling

Reducing waste and promoting recycling are essential aspects of Ethics LG1 Shoes’ manufacturing processes. They employ innovative techniques to minimize waste, such as pattern optimization to maximize material usage and recycling scraps and offcuts. By adopting these practices, they reduce their environmental footprint and contribute to a more circular economy.

Water Conservation

Water is a valuable resource, and Ethics LG1 Shoes recognizes the importance of conserving it. They implement water-saving measures in their manufacturing processes, such as using closed-loop systems for dyeing and finishing. These systems significantly reduce water consumption and minimize water pollution.

The Comfort and Durability of Ethics LG1 Shoes

Ethics LG1 Shoes not only prioritize sustainability but also excel in providing comfort and durability. Their commitment to using high-quality materials and innovative design ensures that their shoes are both comfortable to wear and long-lasting.

Innovative Technologies

Ethics LG1 Shoes integrates innovative technologies into their footwear to enhance comfort and performance. They incorporate cushioning systems, arch support, and breathable materials to provide optimal comfort for all-day wear. These technologies ensure that wearing Ethics LG1 Shoes is a delightful experience.

Quality Craftsmanship

Every pair of Ethics LG1 Shoes is meticulously crafted with attention to detail. The brand prioritizes quality over quantity, ensuring that each shoe meets the highest standards. By using skilled artisans and robust quality control measures, Ethics LG1 Shoes delivers shoes that not only look great but also stand the test of time.

Versatile Designs

Ethics LG1 Shoes offers a wide range of designs that cater to different styles and occasions. Whether you need casual sneakers, formal shoes, or athletic footwear, Ethics LG1 Shoes has you covered. Their versatile designs allow you to make sustainable choices without compromising on your personal style.

Ethics LG1 Shoes and Social Responsibility

More than just a footwear brand, Ethics LG1 Shoes actively engages in social responsibility initiatives to create a positive impact within communities.

Partnerships with Non-Profit Organizations

Ethics LG1 Shoes collaborates with non-profit organizations that align with their values and mission. Through these partnerships, they support various social causes, such as education, poverty alleviation, and environmental conservation. By leveraging their resources and platform, Ethics LG1 Shoes aims to make a tangible difference in society.

Community Outreach Programs

Ethics LG1 Shoes recognizes the importance of giving back to the communities they operate in. They initiate community outreach programs, such as providing educational scholarships, organizing clean-up drives, and supporting local artisans. These programs foster positive change and empower individuals to build a better future.

Employee Volunteerism

Empowering their employees to make a difference, Ethics LG1 Shoes encourages volunteerism. They provide opportunities for their staff to engage in community service and contribute their time and skills to meaningful projects. This employee-driven initiative strengthens the brand’s commitment to social responsibility.

Customer Reviews and Testimonials

Don’t just take our word for it! Read what customers have to say about their experience with Ethics LG1 Shoes.

Unparalleled Comfort

Customers rave about the comfort of Ethics LG1 Shoes. The innovative technologies and thoughtful design elements ensure that each step feels like walking on clouds. Many reviewers mention how they can wear Ethics LG1 Shoes all day without any discomfort or fatigue.

Durability that Lasts

Longevity is a common theme in customer reviews of Ethics LG1 Shoes. Customers appreciate the high-quality craftsmanship and materials that result in shoes that withstand wear and tear. Numerous testimonials mention that their Ethics LG1 Shoes have lasted for years without losing their shape or deteriorating in quality.

Style Meets Sustainability

Style-conscious individuals are thrilled with the aesthetics of Ethics LG1 Shoes. They applaud the brand for offering fashionable designs that align with their personal style choices. Customers appreciate that they can make sustainable fashion statements without compromising on trends or aesthetics.

Ethics LG1 Shoes: A Style Statement

Ethics LG1 Shoes proves that sustainability and style can go hand in hand. Their range of footwear offers something for everyone, allowing you to make a fashion statement while supporting a brand with a conscience.

Elevate Your Wardrobe

With Ethics LG1 Shoes, you can elevate your wardrobe with stylish and on-trend footwear options. From casual sneakers to elegant loafers, there is a pair of Ethics LG1 Shoes to complement any outfit. Their designs cater to various styles, making it easy toachieve a polished and fashionable look without compromising on sustainability.

Versatile and Functional

Ethics LG1 Shoes are not only stylish but also highly versatile. Whether you need shoes for a casual day out, a formal event, or an athletic activity, Ethics LG1 Shoes has a range of options to suit your needs. Their functional designs ensure that you can effortlessly transition from one occasion to another while staying comfortable and fashionable.

Attention to Detail

One of the standout features of Ethics LG1 Shoes is their attention to detail in design. From unique stitching patterns to carefully selected color palettes, every aspect of their footwear is thoughtfully crafted. These small details add an extra touch of style and sophistication, making Ethics LG1 Shoes a go-to brand for fashion-conscious individuals.

How Ethics LG1 Shoes Compare to Other Sustainable Footwear Brands

Ethics LG1 Shoes stands out in the market as a leading sustainable footwear brand, but how do they compare to their competitors? Let’s take a closer look at what sets Ethics LG1 Shoes apart.

Premium Quality at an Affordable Price

While many sustainable footwear brands come with a hefty price tag, Ethics LG1 Shoes offers premium quality at an affordable price point. They believe that sustainability should be accessible to all, and their commitment to fair pricing ensures that customers can make ethical choices without breaking the bank.

Innovative Design and Functionality

Ethics LG1 Shoes takes pride in their innovative design and functionality. They continuously strive to push the boundaries of sustainable footwear, incorporating the latest technologies and design trends. This commitment to innovation sets them apart from other brands and ensures that customers receive cutting-edge products.

Transparency and Accountability

Transparency is a key differentiating factor for Ethics LG1 Shoes. They are open about their manufacturing processes, materials used, and sustainability efforts. This transparency allows customers to make informed choices and trust in the brand’s ethical practices, setting Ethics LG1 Shoes apart from competitors who may not provide the same level of transparency.

Frequently Asked Questions about Ethics LG1 Shoes

Have questions about Ethics LG1 Shoes? We’ve got you covered. Here are answers to some commonly asked questions to help you make an informed decision.

What sizes are available for Ethics LG1 Shoes?

Ethics LG1 Shoes offers a wide range of sizes to cater to various foot shapes and sizes. Their sizes typically range from US sizes 5 to 12 for women and US sizes 7 to 15 for men.

How do I care for my Ethics LG1 Shoes?

Caring for your Ethics LG1 Shoes is easy. Most styles can be cleaned with a damp cloth and mild soap. For specific care instructions, refer to the care label inside your shoes or visit the Ethics LG1 Shoes website for detailed guidelines.

Do Ethics LG1 Shoes come with a warranty?

Yes, Ethics LG1 Shoes come with a warranty against manufacturing defects. The warranty period may vary depending on the specific style of shoe. If you encounter any issues with your Ethics LG1 Shoes, reach out to their customer service team for assistance.

Are Ethics LG1 Shoes suitable for people with wide feet?

Ethics LG1 Shoes offers certain styles that are designed to accommodate wider feet. Look for styles labeled as “wide fit” or check the product descriptions on their website for information on width options. You can also reach out to their customer service team for personalized sizing recommendations.

Are Ethics LG1 Shoes suitable for vegans?

Yes, Ethics LG1 Shoes offers a range of vegan options. They use vegan leather alternatives and other plant-based materials in their vegan-friendly styles. Look for the “vegan” label or check the product descriptions for vegan options on their website.

Where to Buy Ethics LG1 Shoes

Ready to make a sustainable footwear choice? Here are some options for purchasing Ethics LG1 Shoes.

Official Website

The official Ethics LG1 Shoes website is the best place to explore their full range of styles and make a purchase. Their website provides detailed product information, size guides, and secure online ordering for a hassle-free shopping experience.

Authorized Retailers

Ethics LG1 Shoes partners with select retailers who share their commitment to sustainability and ethical practices. Check their website for a list of authorized retailers near you. Shopping from authorized retailers ensures that you are purchasing genuine Ethics LG1 Shoes.

Special Offers and Discounts

Keep an eye out for special offers and discounts on Ethics LG1 Shoes. They occasionally run promotions or have exclusive deals on their website or through their partners. Subscribing to their newsletter or following their social media accounts is a great way to stay updated on these offers.

In conclusion, Ethics LG1 Shoes are more than just a footwear brand. They represent a commitment to sustainability, ethical practices, and style. From their humble beginnings to becoming a leader in sustainable footwear, Ethics LG1 Shoes have set a new standard for the industry. By incorporating sustainable materials, prioritizing ethical manufacturing processes, and contributing to social causes, Ethics LG1 Shoes offers a guilt-free choice for conscious consumers. Experience the comfort, durability, and style of Ethics LG1 Shoes and join the movement towards a greener and more ethical future.

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Ethics lgONE Release Date | Nice Kicks

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Langston Galloway Launches His Own Independent Sneaker, the Ethics lgONEJoey Park | Jan 19, 2022This post may contain affiliate links. Please read our disclosure policy.Where to buy the Ethics lgONE

NBA veteran Langston Galloway debuted his own sneaker brand, Ethics, and the first sneaker, the Ethics lgONE during the NBA Finals last year and after a 2 and a half year journey, the sneaker is now available to the masses.

Galloway is a huge sneakerhead in the NBA circle, so using his knowledge of sneakers as an NBA player and his passion for sneakers as a sneakerhead, it came together for Ethics. Having ownership and being independent is something that Galloway wants to leave for his family and generations after that and with the help of sneaker designer Brett Golliff, the Ethics lgONE was born.

The sneaker uses a cut and sew approach, using raw materials combined with mesh that’s hand-stitched compared to the knits and synthetics seen in the performance basketball market today. Although raw materials are used, it’s still light and flexible with a secure fit and modern shape. The launch colorway is seen in lilac, with a mesh tongue and collar and suede seen on the majority of the upper. A white suede overlay is featured around the toe for durability in high wear areas with the Ethics logo seen on the tongue and heel. A white foam midsole is utilized for impact protection and comfort with a multipatterned translucent outsole to finish off the sneaker.

The Ethics lgONE is available for purchase now on ethicsthebrand.com with a retail price of $120. Check out the official photos below and stay tuned to Nice Kicks for more information on Ethics and the lgONE in the near future.

Ethics lgONE

Release Date:Available Now Price:$120

Ethics Ethics lgONERelated Posts:Union LA Reimagines The Iconic Clark Wallabee with The “Crazy Visions” CollectionClarksMar23The ANTA Kai 1 “KAIverse” Is Limited to Just 323 PairsANTAMar8The Claima x Saucony 3D Grid Hurricane “NOLA” Honors New OrleansSauconyReebok Taps Milk Makeup for Workwear-Inspired CollectionReebokTrending:Dec11Air Jordan 11 “Cool Grey”Air JordansDec10Air Jordan 11 “Cherry”Air JordansFeb13Where to Buy Nike Dunk Low “Dusty Olive”NikeFeb16Where To Buy The Nike Dunk Low “Team Red”NikeJan27Where To Buy The Nike SB Dunk Low “Court Purple”NikeMar12Where To Buy The Nike Dunk Low “Valerian Blue”NikeNice KicksFollow Nice Kicks: © 2024 Nice Kicks. Privacy Policy

SoleSavy Podcast Ep. #114 — NBA Player Langston Galloway | SoleSavy

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Devin Robertson

Jun. 15, 2022 < 1 min readOn this episode, DP is joined by NBA player and owner of ETHICS The Brand, Langston Galloway. Together they talk about the challenges and process of designing a sneaker, owning a brand, the future of ETHICS and his daily tweet.Apple PodcastsSpotifyGoogle PodcastsOvercast0:34 Introduction1:27 What made you go from basketball to starting your own business?3:11 How long ago did you start “Ethics”?5:27 When did you see your first sample?6:22 Breakdown of the ETHICS LG18:58 How many iterations of the LG1 did you go through?10:08 How was the first wear test?11:33 What comes next for ETHICS?14:31 How did the LG1 end up on StockX?15:43 What was the biggest challenge bringing the LG1 to life?19:40 Any words of advice for people just starting out?21:15 What was your go-to sneaker on the court?23:15 Tell us about why you are tweeting the same thing every day

Sole Savy is unreal! With a busy schedule it’s hard to keep up on shoes, and the group keeps me up to date on releases, tips on how to manually cop, and a marketplace with killer deals from fellow like minded collectors. It’s changed the sneaker game for me!@SoleSavy is the truth. They've helped me cop kicks I never would've imagined getting at retail. Members always willing to assist on drops too. And most of all, a REAL community of REAL sneakerheads. These guys should be the gold standard for sneaker communities! #LifetimeMemberMy membership paid for itself three fold by being solely responsible for my union 4’s, mesh sacai waffles, sacai blazers, court purple aj1s, glow in the dark yeezy 350s, travis scott lows (which I traded to get desert ore ow’s), air max 1 londons, bc3’s for way under retail etc.Can't say enough about SS. The stellar help with copping shoes is a given but it's the community that makes it extra special. Hands down one of the best decisions I made as a wannabe sneakerhead.The community of sneakerheads and resources available to help manually cop are great and really will help you get more Ws. The Zoom calls for hyped drops like Union Jordan 4 only adds to the camaraderie while providing real time instruction1 / 5

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Frontiers | Case Report: Anti-LGI1 Limbic Encephalitis Associated With Anti-thyroid Autoantibodies

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CASE REPORT article Front. Neurol., 15 January 2021

Sec. Multiple Sclerosis and Neuroimmunology

Volume 11 - 2020 |

https://doi.org/10.3389/fneur.2020.620483

This article is part of the Research Topic Antibody-mediated autoimmune diseases of the CNS: Challenges and approaches to diagnosis and management View all 40 articles Case Report: Anti-LGI1 Limbic Encephalitis Associated With Anti-thyroid Autoantibodies

Ricardo Otiniano-Sifuentes1Anali Cuba Antezana2Walter F. De La Cruz Ramirez3Kevin Pacheco-Barrios4*Darwin A. Segura Chavez5*

1Department of Neurovascular Diseases, Instituto Nacional de Ciencias Neurológicas, Lima, Peru

2Servicio de Neurología y Neuropsiquiatría, Departamento de Medicina, Hospital Nacional Cayetano Heredia, Lima, Peru

3Departamento de Investigación, Docencia y Atención Especializada en Epilepsia, Instituto Nacional de Ciencias Neurológicas, Lima, Peru

4Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru

5Centro Básico de Investigación en Enfermedades Neuromusculares, Instituto Nacional de Ciencias Neurológicas, Lima, Peru

Anti-LGI1 encephalitis is an autoimmune encephalitis with antibodies against leucine-rich glioma-inactivated 1 (LGI1), first described in 2010. It is a non-frequent and poorly understood entity that represents the second most frequent cause of autoimmune encephalitis. This entity is characterized by the presence of limbic encephalitis, hyponatremia, and faciobrachial dystonic seizures. Herein, we present the case of a male patient with an onset of epileptic seizures (generalized tonic-clonic seizure), and involuntary dystonic movements that affect the right side of his face and right upper limb associated with mental disorder, and affectation of higher functions. The electroencephalogram showed continuous generalized slowing of the background activity. The brain magnetic resonance imaging showed signal hyperintensity at the level of both mesial temporal lobes and hippocampi and in the head of the right caudate nucleus. Anti-thyroglobulin antibodies were positive, and he was initially diagnosed as Hashimoto's encephalopathy (HE). However, the response to corticosteroids was not completed as it is usually observed in HE. For that, antibodies for autoimmune encephalitis were tested, and the anti-LGI1 antibodies were positive in serum and cerebrospinal fluid. HE is an important differential diagnosis to consider. Furthermore, the presence of Anti-thyroglobulin antibodies should not be taken as the definitive diagnostic criteria, since these antibodies could be associated with other autoimmune encephalopathies, which include in addition to anti-LGI1, anti-NMDA and anti-Caspr2.

Background

Anti-LGI1 encephalitis is an autoimmune encephalitis with antibodies against leucine-rich glioma-inactivated 1 (LGI1), first described in 2010 (1). It is a subacute disorder characterized by presenting symptoms of limbic encephalitis such as memory deterioration, epileptic seizures, and behavioral disturbances associated with faciobrachial dystonic seizures (FBDS) and hyponatremia (2, 3). LGI1 limbic encephalitis occurs between the ages of 30–80, being more frequent in males. Changes in brain magnetic resonance imaging (MRI) are usually found in up to 84%. The most frequently affected areas are the medial temporal lobe and the basal ganglia (BG). The cerebrospinal fluid (CSF) study is often normal. However, there may be slight inflammatory changes or the presence of oligoclonal bands (4).

Due to the presence of neuropsychiatric symptoms, Hashimoto's encephalopathy (HE) can be considered as a differential diagnosis. Therefore, the test for antithyroid antibodies (anti-Ty Ab) is necessary. However, the coexistence of these antibodies in other autoimmune diseases, including limbic encephalitides such as anti-NMDAr, Caspr2, and LGI1, must be consider as a potential source of misdiagnosis (5). We present the case of a patient with anti-LG1 encephalitis with the coexistence of anti-Ty Ab initially classified as HE.

Case Presentation

A 77-year-old male with a history of controlled hypertension was brought to our office with an 11-months history that began with a 5-min generalized tonic-clonic seizure (GTCS). At that time, he was therefore treated with phenytoin 100 mg every 8 h. After that he remained asymptomatic. Two months later he presented mental disorder such as irritability and apathy at times. Four months after the symptoms began, altered mental status were added, as well as episodic memory deficit and sleep inversion. These symptoms progress, and after 6 months of illness, he also presented visual hallucinations and involuntary dystonic movements that affect the right side of his face and right upper limb. The episodes occurred several times during the day only seconds long. Two months before admission, apathy progressed, reaching a state of akinetic mutism, and again presented GTCS, for which he is brought to the emergency department.

On neurological examination during hospitalization, the patient had spontaneous ocular opening with poor eye contact, unable to follow simple commands, slurred speech with a tendency to mutism, there was no motor deficit, but he had mild limb mobility, and indifferent plantar reflexes bilaterally. At times he had oromandibular movements associated with myoclonus of the right upper limb.

He had no abnormalities in the hematological exams. Liver profile, lipids, vitamin B12, HIV, and RPR tests were performed without any abnormal finding. Hyponatremia was found (with values between 125 and 135 mEq/L). The electroencephalogram (EEG) showed continuous generalized slowing of the background activity. CSF study revealed normal proteins (17 mg/dL; reference range: 15–45 mg/dL), glucose was 47 mg/dL (reference range: 40–76 mg/dL), and the white cell count was found 1 cell/ mm3 (100% lymphocytes). Oligoclonal bands were not made. The brain MRI showed signal hyperintensity in T1 and FLAIR at the level of both mesial temporal lobes (Figure 1), hippocampi, and in the head of the right caudate nucleus (Figure 2). The thyroid stimulating hormone (TSH) level was 2.83 μIU/mL (reference range: 0.50–5.0 μI/mL) and thyroxine (T4) was 1.09 ng/dL (reference range: 0.93–1.71 μIU/mL). The serum anti-thyroglobulin (anti-Ty) level was 139.6 IU/mL (reference range: <20 IU/mL), and anti-thyroid peroxidase was 268.3 IU/mL (reference range: <35 IU/mL). Given these findings, HE was proposed as a diagnosis, therefore pulses of methylprednisolone were started. After that, there was partial improvement of epileptic seizures and involuntary movements. However, the hyponatremia could not be corrected. An antibody panel for autoimmune encephalitis was requested, supported by the neurological presentation of limbic encephalitis and the findings in the complementary exams.

FIGURE 1

Figure 1. Brain MRI FLAIR protocol, showing signal hyperintensity, and atrophy at the mesial temporal level and bilateral hippocampi.

FIGURE 2

Figure 2. Brain MRI shows signal hyperintensity at the level of the basal nuclei (caudate nucleus head and putamen) on the right side in the FLAIR protocol (A). Discrete hyperintensity is also observed in the same region in the T1 protocol (B).

An antibody panel against autoimmune encephalitis was performed in serum and CSF, which included antibodies anti-N-methyl-D-aspartate receptor (NMDAr), anti-α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPAR), acid receptor g-aminobutyric B (GABAB), and voltage-gated potassium channel (VGKC) complex components such as LGI1 and contactin-associated protein-like 2 (Caspr2). The anti-LGI1 antibody presence was positive in both serum and CSF. The patient received prednisone on a chronic basis, thus achieving better control of the symptoms. The case report timeline is presented in the Figure 3.

FIGURE 3

Figure 3. Case report timeline.

Discussion

We present the case of a male patient with an onset of epileptic seizures associated with mental disorder, and affectation of higher functions with the presence of anti-Ty antibodies who was initially diagnosed as HE. However, the response to corticosteroids was not completed as it is usually observed in HE. This motivated the study of antibodies for autoimmune encephalitis, which was positive for anti-LGI1 antibodies.

Anti-LGI1 autoimmune encephalitis was first described in 2010. It occurs between the ages of 30 to 80 with a predominance in males between the sixth and seventh decade of life. It represents the most common cause of immune-caused limbic encephalitis as well as it is the second most frequent cause of autoimmune encephalitis after anti-NMDAr encephalitis (6). Because of our patient presented suggestive symptoms, a panel of antibodies was requested. However, the unavailability of the test in hospitals in our country and the high cost in private laboratories delayed its results. Despite the increasing number of cases of global anti-LGI1 encephalitis are being reported, our case is the first reported in our country. We believe that poor access to diagnostic testing underestimates the true frequency of autoimmune encephalitis in most Latin American countries.

Our patient also presented involuntary movements that fit the description of FBDS. The nature of these crises is debatable, since some authors consider it to be of subcortical origin while others defend its cortical origin in relation to epileptic seizures. They are described as contractions of one side of the face with flexion of the shoulder, arm, wrist, and ipsilateral finger extension that last <3 s and occur several times during the day (7). They usually precede cognitive decline and GTCS. However, in our case, the patient debuted with GTCS, and FBDS that occurred at 6 months of illness along with cognitive decline. This manifestation is almost pathognomonic of this diagnosis, it happens between 20 and 70% of cases (8, 9). Besides in a series of 13 cases by Wang et al. indicated that all of his patients presented this finding (6). Therefore, it is important to recognize this clinical manifestation and its relationship with anti-LGI1 encephalitis.

Other important findings described in anti-LGI1 encephalitis are hyponatremia, mental disorders, and sleep alterations (5). Hyponatremia is reported in up to 65% of cases and it is usually refractory to treatment (3), probably in association with a syndrome of inappropriate antidiuretic hormone secretion due to the presence of LG1 receptors in the hypothalamus and kidney. In our patient, sodium levels could not be normalized during their hospital stay. Although there was a slight increase in blood sodium level after the start of corticosteroid therapy. This is aligned with the literature showing that the blood sodium level reflects the severity of the disease (9); since our patient was severely compromised.

Behavioral disorders can be very diverse. Our patient presented apathy and irritability. Apathy is reported in up to 54%, while the frequency of organic irritability or excitation was presented in 39% of the cases (6). The EEG continuous generalized slowing of the background activity, without epileptogenic discharges, and the CSF study showed no abnormalities, which is consistent with previous the literature (4, 6).

The brain MRI presented hypersignals in both hippocampi bilaterally in FLAIR, in addition to hypersignal in T1 and FLAIR int right BG; these findings were described in previous case series (4, 6). It should be noted that in previous reports the unilateral hypersignal in BG (in FLAIR), correlates with contralateral FBDS. In our case, this hypersignal was ipsilateral and not contralateral to his FBDS. However, it does not rule out that FBDSs on the left side could have gone unnoticed, which is frequent in this condition (6, 10).

One of the differential diagnosis is HE (9), also known as steroid-sensitive encephalopathy associated with autoimmune thyroiditis, which is a clinically heterogeneous entity, traditionally defined as an encephalopathy associated with the presence of antithyroid antibodies. Our patient was initially diagnosed as HE due to neurological and psychiatric symptoms, and the presence of anti-Ty antibodies. However, these antibodies have shown to be not very specific to define this disease, and a factor of overdiagnosis; since, they have also been evidenced in other immune-mediated disorders, such as some autoimmune encephalitis, and even in up to 13% of the normal population (11).

Tüzün et al. (12), detected anti-Ty antibodies in eight of 24 patients with limbic encephalitis, and in this group of patients the antineuronal antibodies were the most frequent finding. The low specificity of antithyroid antibodies to define HE and their coexistence with other antibodies that define various autoimmune encephalitis suggests that these are only part of an epiphenomenon triggered by the antineuronal antibody and forces the need to refocus studies toward the systematic exclusion of antineuronal antibodies in patients with symptoms suggestive of immune-mediated encephalitis; even in those with antithyroid antibodies. It is important to note that antibody testing should not be a requirement to start the treatment if there is a high clinical suspicion. Opposite behavior can have a significant negative impact, since it is known that the prognosis, especially cognitive, in this entity is related to timely treatment. Likewise, it is important to highlight that high doses of IV steroids followed by prolonged oral steroids seem to be more effective in LGI1 antibody encephalitis, as occurred in our case (10).

Conclusion

Anti-LGI1 encephalitis is a non-frequent and poorly understood entity that represents the second most frequent cause of autoimmune encephalitis. It is distinguished by the presence of limbic encephalitis, hyponatremia, and FBDS. HE is an important differential diagnosis to consider. Furthermore, the presence of anti-Ty antibodies should not be taken as the definitive diagnostic criteria, since these antibodies could be associated with other autoimmune encephalopathies, which include in addition to anti-LGI1, anti-NMDA and anti-Caspr2. In resource-limited countries with difficult access to the antibody test, it should be noted that it may be cheaper than requesting repeat MRIs. Even more so considering that anti-LGI1 encephalitis presents characteristic findings in MRI that should not generate uncertainty.

Data Availability Statement

The original contributions presented in the study are included in the article/supplementary material, further inquiries can be directed to the corresponding author/s.

Ethics Statement

The studies involving human participants were reviewed and approved by National Institute of Neurological Sciences. The patients/participants provided their written informed consent to participate in this study.

Author Contributions

RO-S, AC, and WD contributed to the conception and data collection. KP-B and DS contributed to developing the idea of the study and revising the article critically for important intellectual content. All authors contributed to the article and approved the submitted version.

Funding

Dr. Josep Dalmau and the IDIBAPS laboratory in Barcelona for their support with the antibody panel in the study of this patient.

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

References

1. Rosenfeld MR, Dalmau JO. Paraneoplastic disorders of the CNS and autoimmune synaptic encephalitis. Continuum. (2012) 18:366–83. doi: 10.1212/01.CON.0000413664.42798.aa