Document Detail


Steroid-responsive recurrent limbic encephalitis associated with small cell lung cancer and neuropil antibodies.
MedLine Citation:
PMID:  21748934     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
Paraneoplastic limbic encephalitis (PLE) associated with small cell lung cancer (SCLC) often presents with antibodies to intracellular antigens and a poor outcome even after tumor resection and immunotherapy. We report a PLE patient presenting with generalized seizures, shortterm memory impairment and medial temporal lobe hyperintensity in MRI. Initial screening revealed significantly elevated thyroid antibody levels suggesting Hashimoto's encephalopathy. Following methylprednisolone treatment, her seizures ceased, MRI findings disappeared and memory impairment showed a partial resolution in 5 months. Two months later, she developed further generalized seizures. Chest X-ray showed a mass lesion, which was demonstrated by needle biopsy to be a small cell lung carcinoma (SCLC). The panel of onconeural antibodies including cell-membrane antigens was negative. However, the patient's serum and cerebrospinal fluid IgG, obtained during both exacerbations, immunolabeled cytoplasm and dendrites of Purkinje cells, cerebellar and hippocampal molecular layers, basal ganglia, thalamus, and the surface of cultured hippocampal neurons, in a manner distinct from previously identified neuropil antibodies associated with SCLC. These neuropil antibodies appear to be associated with a favorable response to treatment. Further studies are required for determination of the target antigen.
Authors:
Erdem Tüzün; Erdem Yaka; Luigi Zuliani; Sema Içöz; Bariş Baklan; Omer Birişik; Pinar Kurd; Gülşen Akman-Demir; Angela Vincent; Gülden Akdal
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta neurologica Belgica     Volume:  111     ISSN:  0300-9009     ISO Abbreviation:  Acta Neurol Belg     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-07-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0247035     Medline TA:  Acta Neurol Belg     Country:  Belgium    
Other Details:
Languages:  eng     Pagination:  139-42     Citation Subset:  IM    
Affiliation:
Istanbul University, Istanbul Faculty of Medicine, Department of Neurology, Istanbul, Turkey. drerdem@yahoo.com
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