Document Detail


Anti-Hu-associated brainstem encephalitis.
MedLine Citation:
PMID:  19015226     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: A series of patients with anti-Hu-associated brainstem encephalitis is reviewed to better define the clinical presentation and to improve its recognition. METHODS: Data were collected from 14 patients diagnosed by members of the Paraneoplastic Neurological Syndromes Euronetwork, and eight patients from the literature who presented with isolated brainstem encephalitis and had anti-Hu antibodies. RESULTS: The median age of the 22 patients was 64 years (range 42-83), and 50% were men. All patients developed a subacute neurological syndrome, in days or weeks. Brain MRI was always normal. Mild cerebrospinal fluid pleocytosis was reported in only two patients. The following syndromes were identified on admission: A medullary syndrome was seen in 11 (50%) patients. Seven of them presented with dysphagia, dysarthria and central hypoventilation. The other four in addition of bulbar symptoms, without central hypoventilation, presented pontine manifestations. Six (27%) patients developed a pontine syndrome with paresis of the VI or VII cranial nerves, nystagmus, usually vertical, and gait ataxia. There was a rapid downward progression to the medulla in all patients. Five (23%) patients presented a ponto-mesencephalic syndrome with uni- or bilateral palsy of the III and VI cranial nerves and gait ataxia, but rapidly progressed to complete gaze paresis and medullary dysfunction. CONCLUSIONS: The study confirms the predominant medullary involvement but also shows that half of the patients present with clinical features that indicate an upper, mainly pontine, dysfunction before downward progression.
Authors:
A Saiz; J Bruna; P Stourac; M C Vigliani; B Giometto; W Grisold; J Honnorat; D Psimaras; R Voltz; F Graus
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-11-17
Journal Detail:
Title:  Journal of neurology, neurosurgery, and psychiatry     Volume:  80     ISSN:  1468-330X     ISO Abbreviation:  J. Neurol. Neurosurg. Psychiatr.     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-03-17     Completed Date:  2009-04-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  2985191R     Medline TA:  J Neurol Neurosurg Psychiatry     Country:  England    
Other Details:
Languages:  eng     Pagination:  404-7     Citation Subset:  IM    
Affiliation:
Servei de Neurologia, Hospital Clinic, Barcelona, Spain.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Antineoplastic Agents / therapeutic use
Brain Stem Neoplasms / pathology*
Female
Hu Paraneoplastic Encephalomyelitis Antigens / immunology*
Humans
Immunotherapy
Male
Medulla Oblongata / pathology
Mesencephalon / pathology
Middle Aged
Neurosurgical Procedures
Paraneoplastic Syndromes, Nervous System / pathology*,  surgery,  therapy*
Pons / pathology
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antineoplastic Agents; 0/Hu Paraneoplastic Encephalomyelitis Antigens

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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