To our knowledge, this is the first reported case involving both VGKC complex protein antibody encephalitis and fasciculations associated with kinesigenic dyskinesia. Because of the patient's history of 2 autoimmune diseases—vitiligo and immune complex mesangiopathic glomerulonephritis—and negative cancer evaluation findings, we believed that the VGKC encephalitis and the peripheral cramp-fasciculation syndrome were on an autoimmune basis. He had the typical clinical presentation for the VGKC antibody spectrum disease, including seizures and memory and cognitive impairment, supported by the laboratory findings of a slow electroencephalogram, hyponatremia, and an elevated antibody titer. Two other patients have been described with caudate and putaminal lesions associated with this syndrome.1,2 Two clinically similar cases have also been reported,3,4 but, unlike our patient, both patients had clear electroencephalographic abnormalities, and neither had basal ganglia lesions on magnetic resonance images. Our patient is unique in that he developed kinesigenic dyskinesia and asymptomatic cramp-fasciculation syndrome. Also, he did not complain of any of the typical symptoms of peripheral nerve hyperexcitability that have been described in association with VGKC antibody spectrum diseases (neuromyotonia or Isaacs syndrome, cramp-fasciculation syndrome, and Morvan syndrome).5- 9 He did, however, have prominent fasciculations, especially in the lower extremities.