1/17. limbic encephalitis and hyperactive foci on PET scan.Two cases of patients with paraneoplastic limbic encephalitis, difficult to control seizures, and unilateral hippocampal hypermetabolism on positron emission tomography (PET) are described. Two women aged 33 and 61 presented with uncontrolled complex partial seizures, profound memory loss and cognitive decline. One was later diagnosed with breast cancer and the other with lung cancer. Video-EEG on the first patient recorded multifocal sharp waves and bilateral independent seizure onsets. The second patient had no epileptiform discharges and bitemporal ictal onset, even though the clinical seizures suggested a right temporal onset. magnetic resonance imaging (MRI) was normal in both patients. PET scans obtained in the interictal state showed right hippocampal hypermetabolism in both patients. In the second patient, the lung cancer was irradiated with resolution of seizures and improvement of memory function. A PET scan six months later was normal. Subsequent seizure recurrence and worsening of memory led to the discovery of widespread metastases. limbic encephalitis should be considered in the differential diagnosis of intractable partial epilepsy, particularly if accompanied by severe memory loss and cognitive decline. Treatment of the underlying cancer may be lead to improved seizure control. Hippocampal hypermetabolism may be a common feature on PET, and may indicate subclinical seizure activity.- - - - - - - - - - ranking = 1keywords = cancer (Clic here for more details about this article) |
2/17. limbic encephalitis and antibodies to Ma2: a paraneoplastic presentation of breast cancer.A patient with atypical medullary breast cancer is described who presented with symptoms of limbic encephalitis. The patient's serum and CSF contained antibodies that reacted with the nervous system and the tumour. These antibodies recognised Ma2, a neuronal protein related to paraneoplastic limbic and brainstem encephalitis in men with testicular tumours. This report highlights the importance of testing for paraneoplastic antineuronal antibodies in cases of unexplained limbic encephalitis and suggests screening for breast cancer in women with antibodies predominantly directed to Ma2.- - - - - - - - - - ranking = 1.5keywords = cancer (Clic here for more details about this article) |
3/17. limbic encephalitis not associated with neoplasm as a cause of temporal lobe epilepsy.OBJECTIVE: To describe four patients with temporal lobe epilepsy with limbic encephalitis unrelated to neoplasm. methods: The authors performed a retrospective evaluation of patient data obtained during presurgical evaluation, with additional CSF analyses, serum analyses, and histopathologic investigations. RESULTS: The patients shared the following clinical features: onset of the disease in young adulthood with subacute onset or exacerbation of frequent intractable temporal lobe seizures, verbal and visual memory deficits, and affective abnormalities. MRI showed variably extended areas of increased T2 signal in limbic structures and adjacent areas. In the histopathologic investigation, chronic inflammation was observed without evidence of a viral origin. There was no evidence of an underlying malignancy. CONCLUSIONS: Nonparaneoplastic limbic encephalitis should be included in the differential diagnosis of adult patients with temporal lobe epilepsy.- - - - - - - - - - ranking = 0.0043463197864026keywords = neoplasm (Clic here for more details about this article) |
4/17. memory lost, memory regained: neuropsychological findings and neuroimaging in two cases of paraneoplastic limbic encephalitis with radically different outcomes.OBJECTIVE: To report two cases of paraneoplastic limbic encephalitis (PNLE) with similar clinical presentation, but dramatically different outcome and to highlight the role of neuropsychological and radiological evaluation in PNLE. methods: Both patients underwent an extensive battery of neuropsychological tests designed to document general intellectual function, anterograde verbal and visual memory, naming, knowledge and executive ability. In addition, structural (CT and MRI) and functional (HMPAO-SPECT) brain scans were performed. RESULTS: Both patients presented with fairly sudden onset of profound and persistent memory loss in the absence of other neurological symptoms. Their subsequently diagnosed small cell lung cancer was treated with a combination of radiotherapy and chemotherapy, leading to remission of the tumour. The memory of patient 1 recovered fully and he died from an unrelated cause 1 year later; neuropsychological testing showed a severe, but isolated, anterograde amnesia, brain MRI was normal and HMPAO-SPECT showed left medial temporal hypoperfusion. Patient 2 remained densely amnesic despite regression of her lung tumour; neuropsychological testing disclosed both anterograde and extensive retrograde amnesia together with more generalised cognitive deficits including anomia and executive impairments, MRI showed gross atrophy of the hippocampus and amygdala bilaterally, and HMPAO-SPECT showed pronounced frontal and temporal hypoperfusion. CONCLUSION: Complete remission from PNLE may occur and seems to be associated with pure anterograde amnesia without evidence of structural hippocampal damage in MRI. By contrast, cognitive deficits beyond severe anterograde amnesia and evidence of destructive medial temporal lobe pathology on MRI seem to be poor prognostic features.- - - - - - - - - - ranking = 0.25keywords = cancer (Clic here for more details about this article) |
5/17. Paraneoplastic limbic encephalitis, a complication of the testicular cancer.We report a case of paraneoplastic limbic encephalitis related to a testicular neoplasm. The syndrome is characterized by progressive amnesia and psychiatric disturbances resulting from an inflammatory reaction probably related to an immune response to the neuronal proteins expressed by tumors. It is usually associated with small cell lung cancer. In other cases, testicular cancer occurs more frequently than expected. Cranial magnetic resonance imaging may show increased signal intensity in the limbic cortex. Genitourinary examinations are sometimes inadequate. Testicular ultrasonography is recommended if no tumor is detected on the chest and abdominal computed tomography scan. The outcome of the treatment of the testicular cancer on the paraneoplastic syndrome is variable.- - - - - - - - - - ranking = 34.45442577212keywords = testicular cancer, cancer, neoplasm (Clic here for more details about this article) |
6/17. Paraneoplastic limbic encephalitis: case report.Paraneoplastic limbic encephalitis, which is also known as the remote neurological effect of cancer, is a rare neurological paraneoplastic disorder that usually presents with changes in mental status and behavioral abnormalities. Paraneoplastic limbic encephalitis had been diagnosed by clinical, laboratory and pathological studies in the pre-MRI era, but the diagnosis became much easier with MRI. We present MRI pictures of a case of paraneoplastic limbic encephalitis associated with small cell carcinoma of the lung.- - - - - - - - - - ranking = 0.25keywords = cancer (Clic here for more details about this article) |
7/17. Successful immune treatment for non-paraneoplastic limbic encephalitis.A 21-year-old woman subacutely developed memory loss subsequent to gastroenteritis. brain MRI with gadolinium enhancement showed symmetric involvement of the amygdala. The CSF was acellular with increased protein level. There was no evidence suggestive of neoplasm or viral infection. Combined treatment with plasmapheresis and immunoglobulin improved her clinical symptoms and lessened abnormalities manifested in the MRI. This case suggests the presence of immune-mediated limbic encephalitis without association with neoplasms or infections.- - - - - - - - - - ranking = 0.001738527914561keywords = neoplasm (Clic here for more details about this article) |
8/17. Resolution of limbic encephalitis with detection and treatment of lung cancer: clinical-radiological correlation.Paraneoplastic limbic encephalitis may develop in the setting of an otherwise occult malignancy. In the case reported here, the neuropsychiatric syndrome resolved with treatment of the underlying, previously undiagnosed small-cell lung cancer, and MR imaging showed resolution of the characteristic temporal lobe signal abnormalities.- - - - - - - - - - ranking = 1.25keywords = cancer (Clic here for more details about this article) |
9/17. Paraneoplastic limbic encephalitis and possible narcolepsy in a patient with testicular cancer: case study.We describe a patient who presented with a clinical syndrome of limbic encephalitis, narcolepsy, and cataplexy. The anti-Ma2 antibody was positive. Although there was no mass on imaging, orchiectomy was performed in this patient, and testicular carcinoma was found. This is the first known case of limbic encephalitis and anti-Ma2 antibody to be associated with cataplexy and possible narcolepsy. Neurological symptoms precede the diagnosis of cancer in 50% of patients with paraneoplastic syndromes, and clinicians are therefore strongly advised to evaluate patients with neurological symptoms for this condition.- - - - - - - - - - ranking = 23.052371005442keywords = testicular cancer, cancer (Clic here for more details about this article) |
10/17. Complicated paraneoplastic neurological syndromes: a report of two patients with small cell or non-small cell lung cancer.Paraneoplastic neurological syndromes are frequently associated in patients with small cell lung cancer (SCLC) and antineuronal antibodies are involved in the autoimmune mechanism. Multiple syndromes are sometimes complicated in a single patient with SCLC. However, little is known about non-SCLC-associated neurological manifestations. We report two patients with complicated paraneoplastic neurological syndromes. Patient 1 showed paraneoplastic limbic encephalitis (PLE), paraneoplastic sensory neuropathy (PSN) and lambert-eaton myasthenic syndrome (LEMS) associated with SCLC. Patient 2 developed opsoclonus-ataxia and probable PLE associated with non-SCLC. Analysis of various antineuronal antibodies revealed that anti-Hu and P/Q-type voltage-gated calcium channel (VGCC) antibodies were positive in Patient 1 but any antibodies were not in Patient 2. brain MRI demonstrated high intensity signals in temporal lobes particularly on fluid-attenuated inversion recovery (FLAIR) or diffusion-weighted images. These findings suggest that complicated paraneoplastic neurological syndromes occur in non-SCLC as well as SCLC and that unidentified antineuronal autoantibodies may underlie the pathophysiology.- - - - - - - - - - ranking = 1.25keywords = cancer (Clic here for more details about this article) |
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