| Anti-Hu-associated brainstem encephalitis. | |
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MedLine Citation:
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PMID: 19015226 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2008-11-17 |
Journal Detail:
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Title: Journal of neurology, neurosurgery, and psychiatry Volume: 80 ISSN: 1468-330X ISO Abbreviation: J. Neurol. Neurosurg. Psychiatr. Publication Date: 2009 Apr |
Date Detail:
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Created Date: 2009-03-17 Completed Date: 2009-04-20 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 2985191R Medline TA: J Neurol Neurosurg Psychiatry Country: England |
Other Details:
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Languages: eng Pagination: 404-7 Citation Subset: IM |
Affiliation:
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Servei de Neurologia, Hospital Clinic, Barcelona, Spain. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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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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