Clinical, Magnetic Resonance Imaging, and Electroencephalographic Findings in Paraneoplastic Limbic Encephalitis

Lawn, Nicholas; Westmoreland, Barbara F.; Kiely, Michael J.; Lennon, Vanda A.; Vernino, Steven

doi:10.4065/78.11.1363

Cited by 228 publications

(149 citation statements)

References 22 publications

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“…In 65%-80% of patients with predominant limbic encephalitis, MRI and CT show temporal lobe abnormalities [32,33]. Patients with a predominant cerebellar syndrome will develop cerebellar atrophy in the chronic stage.…”

Section: Diagnostic Evaluationmentioning

confidence: 99%

“…MRI and CT scans are abnormal in 65%-80% of patients [32,33]. Abnormalities consist of increased signal on T2-weighted and fluid-attenuated inversion-recovery images of one or both medial temporal lobes, hypothalamus, and brainstem.…”

Section: Diagnostic Evaluationmentioning

confidence: 99%

“…The associated tumor is a lung tumor in 50%-60% of patients, usually SCLC (40%-55%), and the associated tumor is a testicular germ cell tumor in 20% of patients [32,33,38]. Other tumors include breast cancer, thymoma, Hodgkin's disease, and immature teratomas [32,33].…”

Section: Underlying Tumormentioning

confidence: 99%

“…Symptoms are usually confined to the limbic system, hypothalamus, and brainstem. The third group has no antineuronal antibodies (approximately 40% of patients with PLE) [32,33]). In these patients, the symptoms are more often confined to the limbic system, the median age is around 57 years, and the associated tumor is often located in the lung [33,38].…”

Section: Limbic Encephalitismentioning

confidence: 99%

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Managing Paraneoplastic Neurological Disorders

2006

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Section: Diagnostic Evaluationmentioning

confidence: 99%

Section: Diagnostic Evaluationmentioning

confidence: 99%

Section: Underlying Tumormentioning

confidence: 99%

Section: Limbic Encephalitismentioning

confidence: 99%

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Managing Paraneoplastic Neurological Disorders

2006

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“…3 To our knowledge, this is only the second case of PLE associated with squamous cell lung carcinoma reported in the literature. 4 In most case series, between 54 and 80% of lung cancer-associated PLE is due to small cell lung cancer, is anti-Hu antibody-positive (the most well recognized anti-neuronal antibody 5 ), and has a poor outcome. 3,4,6,7 It is interesting to note that anti-neuronal antibodies such Hu were not identified in this case, and indeed, we may postulate that the culprit autoantibody associated with squamous cell cancer has yet to be identified.…”

Section: Discussionmentioning

confidence: 99%

Squamous Cell Lung Carcinoma Presenting With Refractory Status Epilepticus: A Case Report of Paraneoplastic Limbic Encephalitis

Hurley¹,

Herron²,

McDermott³

et al. 2015

Respir Care

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Lung cancer-associated paraneoplastic syndromes affecting the central nervous system present significant diagnostic and treatment challenges. In this case, the patient presented with personality change, cognitive impairment, complex partial seizures, ataxia, dyspraxia, and dysphasia. Shortly after admission, the patient suffered refractory generalized tonic-clonic seizures and a decreased level of consciousness and required intubation, ventilation, and admission to the ICU. He was subsequently diagnosed with paraneoplastic limbic encephalitis based on recognized criteria, including a compatible clinical picture, elevated protein content in his cerebrospinal fluid with negative cytology, a positive positron emission tomography-computed tomography scan showing a right upper lobe tumor, and the exclusion of other neuro-oncological complications. Histopathology confirmed the tissue diagnosis as squamous cell cancer. Initial immunotherapy with steroids and intravenous immunoglobulin and subsequent lobectomy and adjuvant chemotherapy were partially successful, leading to partial resolution of his cognitive impairment. This report highlights the diagnostic and therapeutic challenges of lung-related paraneoplastic syndromes. In addition, it illustrates the poor outcomes for patients and identifies squamous cell cancer as an extremely rare cause of paraneoplastic limbic encephalitis.

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Steroid-Responsive Encephalopathy Associated With Autoimmune Thyroiditis

et al. 2006

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Background: Steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT), often termed Hashimoto encephalopathy, is a poorly understood and often misdiagnosed entity. Objective: To characterize the clinical, laboratory, and radiologic findings in patients with SREAT to potentially improve recognition of this treatable entity. Design: Retrospective analysis of clinical features and diagnostic test data. Setting: Two affiliated tertiary care referral institutions. Patients: Twenty consecutive (6 male) patients diagnosed as having SREAT from 1995 to 2003. Main Outcome Measures: Clinical features and ancillary test findings associated with SREAT. Results: The median age at disease onset was 56 years (range, 27-84 years). The most frequent clinical features were tremor in 16 (80%), transient aphasia in 16 (80%), myoclonus in 13 (65%), gait ataxia in 13 (65%), seizures in 12 (60%), and sleep abnormalities in 11 (55%). All patients were assigned an alternative misdiagnosis at

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Clinical, Magnetic Resonance Imaging, and Electroencephalographic Findings in Paraneoplastic Limbic Encephalitis

Cited by 228 publications

References 22 publications

Managing Paraneoplastic Neurological Disorders

Managing Paraneoplastic Neurological Disorders

Squamous Cell Lung Carcinoma Presenting With Refractory Status Epilepticus: A Case Report of Paraneoplastic Limbic Encephalitis

Steroid-Responsive Encephalopathy Associated With Autoimmune Thyroiditis

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