Document Detail


Limbic encephalitis presenting with seizures, anterograde amnesia, and psychosis in a patient seven weeks status post immature ovarian teratoma removal.
MedLine Citation:
PMID:  20731268     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A paraneoplastic syndrome associated with anti-N-methyl-D-asparate (NMDA) receptors can initially present as a neurologic or psychiatric disturbance. Removal of the tumor is usually curative, and the syndrome is associated with the presence, rather than the history, of tumor. We present a case in which a 25-year-old, Hispanic woman presented with seizures, memory loss, and unusual behavioral changes. The woman had a teratoma removed 2 months earlier. Because of the time course, a paraneoplastic syndrome was initially considered unlikely. Brain imaging, electroencephalography (EEG) and neurologic work-up were negative. The patient was treated for a suspected somatoform disorder and psychosis. Based on the clinical picture, the working diagnosis was changed to delirium due to paraneoplastic limbic encephalitis. A course of intravenous immunoglobins (IVIg), and high dose steroids was administered. The patient's symptoms improved, and she was discharged home. After discharge, studies came back positive for antibodies against NR1/NR2 of the NMDA receptor.
Authors:
Brian Kleyensteuber; Victor Ruterbusch; Jason Bennett; David Llewellyn; George Loeffler
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Military medicine     Volume:  175     ISSN:  0026-4075     ISO Abbreviation:  Mil Med     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-08-24     Completed Date:  2010-09-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  2984771R     Medline TA:  Mil Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  616-8     Citation Subset:  IM    
Affiliation:
Department of Mental Health, Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA 92134, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Amnesia, Anterograde / diagnosis*,  drug therapy
Diagnosis, Differential
Diagnostic Imaging
Electroencephalography
Female
Humans
Immunoglobulins, Intravenous / therapeutic use
Limbic Encephalitis / diagnosis*,  drug therapy
Ovarian Neoplasms / surgery
Paraneoplastic Syndromes / diagnosis*,  drug therapy
Psychotic Disorders / diagnosis*,  drug therapy
Seizures / diagnosis*,  drug therapy
Steroids / therapeutic use
Teratoma / surgery
Chemical
Reg. No./Substance:
0/Immunoglobulins, Intravenous; 0/Steroids

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


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