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https://www.readbyqxmd.com/read/28101036/anti-n-methyl-d-aspartate-receptor-encephalitis-in-hiv-infection
#1
Eunice Patarata, Vera Bernardino, Ana Martins, Rui Pereira, Conceição Loureiro, Maria Francisca Moraes-Fontes
Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a rare condition characterized by emotional and behavioral disturbances, dyskinesias, and extrapyramidal signs. It occurs in young women of reproductive age and is classically described as a paraneoplastic phenomenon. We present a 36-year-old, HIV-positive female who was admitted to the hospital in an acute confusional state, with a stiff posture, periods of motor agitation, and myoclonic jerks of the hands. Her mental state progressively deteriorated...
September 2016: Case Reports in Neurology
https://www.readbyqxmd.com/read/28063151/gad65-neurological-autoimmunity
#2
Andrew McKeon, Jennifer A Tracy
The glutamic acid decarboxylase 65-isoform (GAD65) antibody is a biomarker of autoimmune central nervous system (CNS) disorders and, more commonly, non-neurological autoimmune diseases. Type 1 diabetes, autoimmune thyroid disease, and pernicious anemia are the most frequent GAD65 autoimmune associations. One or more of these disorders coexists in approximately 70% of patients with GAD65 neurological autoimmunity. Neurological phenotypes have CNS localization and include limbic encephalitis, epilepsy, cerebellar ataxia, and stiff-person syndrome (SPS), among others...
January 7, 2017: Muscle & Nerve
https://www.readbyqxmd.com/read/28018466/a-young-child-of-anti-nmda-receptor-encephalitis-presenting-with-epilepsia-partialis-continua-the-first-pediatric-case-in-korea
#3
Eun-Hee Kim, Yeo Jin Kim, Tae-Sung Ko, Mi-Sun Yum, Jun Hwa Lee
Anti-N-methyl D-aspartate receptor (anti-NMDAR) encephalitis, recently recognized as a form of paraneoplastic encephalitis, is characterized by a prodromal phase of unspecific illness with fever that resembles a viral disease. The prodromal phase is followed by seizures, disturbed consciousness, psychiatric features, prominent abnormal movements, and autonomic imbalance. Here, we report a case of anti-NMDAR encephalitis with initial symptoms of epilepsia partialis continua in the absence of tumor. Briefly, a 3-year-old girl was admitted to the hospital due to right-sided, complex partial seizures without preceding febrile illness...
November 2016: Korean Journal of Pediatrics
https://www.readbyqxmd.com/read/27941376/paraneoplastic-syndrome-with-anti-nmdar-encephalitis-associated-with-ovarian-teratomas
#4
Puskar Pattanayak, Lilja B Solnes
We report on a 33-year-old woman who had a paraneoplastic syndrome with anti-N-methyl-d-aspartate receptor encephalitis, associated with ovarian teratomas. She presented with acute onset seizures, grandiosity, elevated mood, disorganized thoughts, and paranoia. Cerebral spinal fluid analysis revealed anti-N-methyl-d-aspartate receptor antibodies. A PET/CT was requested, which identified a possible fat and calcification containing right adnexal lesion on the noncontrast CT portion, which was suspicious for a teratoma...
December 9, 2016: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/27919056/autoimmune-choreas
#5
REVIEW
Francisco Cardoso
Chorea, a movement disorder characterised by a continuous flow of unpredictable muscle contractions, has a myriad of genetic and non-genetic causes. Although autoimmune processes are rare aetiology of chorea, they are relevant both for researchers and clinicians. The aim of this article is to provide a review of the epidemiology, clinical and laboratory features, pathogenesis and management of the most common autoimmune causes of chorea. Emphasis is given particularly to Sydenham's chorea, systemic lupus erythematosus, primary antiphospolipid antibody syndrome, paraneoplastic chorea and anti-N-methyl-d-aspartate receptor encephalitis...
December 1, 2016: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/27893699/nivolumab-induced-severe-akathisia-in-an-advanced-lung-cancer-patient
#6
Jiro Abe, Taku Sato, Ryota Tanaka, Toshimasa Okazaki, Satomi Takahashi
BACKGROUND Nivolumab is an anti-PD-1 immune checkpoint inhibitor that was recently developed for cancer immunotherapy. In the clinical trials of nivolumab, its adverse effects were reported to be less likely than those of conventional anti-cancer agents; however, after practical clinical distribution, it has come to be known that nivolumab induces various immune-related adverse events. CASE REPORT A 58-year-old male with a recurrence of lung adenocarcinoma was treated with nivolumab. Only four days after the initial administration of nivolumab, the patient presented with unbearable restlessness and distress that was resistant to all therapeutic agents used, and it gradually became worse...
November 23, 2016: American Journal of Case Reports
https://www.readbyqxmd.com/read/27855355/seizure-control-and-cognitive-improvement-via-immunotherapy-in-late-onset-epilepsy-patients-with-paraneoplastic-versus-gad65-autoantibody-associated-limbic-encephalitis
#7
N Hansen, G Widman, J-A Witt, J Wagner, A J Becker, C E Elger, C Helmstaedter
OBJECTIVE: To determine the efficacy of immunotherapy in limbic encephalitis (LE) associated epilepsies with autoantibodies against intracellular antigens in the forms of paraneoplastic autoantibodies versus glutamic acid decarboxylase 65 (GAD)-autoantibodies. METHODS: Eleven paraneoplastic-antibodies+ and eleven age- and gender-matched GAD-antibodies+ patients with LE were compared regarding EEG, seizure frequency, MRI volumetry of the brain, and cognition. All patients received immunotherapy with corticosteroids add-on to antiepileptic therapy...
December 2016: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/27823947/coexisting-neuronal-autoantibodies-among-children-with-demyelinating-syndromes
#8
Hikmet Kıztanır, Gonca Bektaş, Edibe Pembegül Yıldız, Tuğçe Aksu Uzunhan, Burak Tatlı, Nur Aydınlı, Mine Çalışkan, Meral Özmen
OBJECTIVES: To determine the incidence and clinical relevance of neuronal autoantibodies in children with demyelinating syndromes. METHODS: We conducted a prospective study including 31 consecutive children with demyelinating syndromes. Four patients with N-Methyl-D-aspartate receptor (NMDAR) encephalitis, 32 patients with Guillain-Barre syndrome, 13 children with benign childhood epilepsy, and 28 healthy children were used as controls. Prior to initiating immunomodulatory therapy, serum samples were tested for antibodies against NMDAR, α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor (AMPAR) 1, AMPAR2, leucine-rich glioma-activated protein 1, contactin-associated protein 2, gamma-aminobutyric acid B receptors, paraneoplastic ma antigen 2 (PNMA2/Ta), Yo, Ri, Hu, CV2, amphiphysin, and aquaporin-4 by indirect immunofluorescence assays...
November 4, 2016: Brain & Development
https://www.readbyqxmd.com/read/27806421/-autoimmune-mediated-encephalomyelitis-a-heterogeneous-entity-in-between-neurology-and-psychiatry
#9
U K Zettl, A Dudesek, F Rimmele, H Zettl, R Patejdl
Within the last decade, autoantibody-associated encephalitis and encephalomyelitis have stepped into the focus of clinical research and practice. Besides the "classic" autoantibodies against intracellular neuronal antigenes, a growing number of antibodies directed against pre- and postsynaptic surface proteins of neurons have been described since the millennium change. Whereas the "classic" are closely linked to paraneoplastic syndromes, this association is loose for most of the yet known surface antigen-antibodies...
October 2016: Fortschritte der Neurologie-Psychiatrie
https://www.readbyqxmd.com/read/27778112/anti-n-methyl-d-aspartate-receptor-encephalitis-associated-with-intracranial-angiostrongylus-cantonensis-infection-a-case-report
#10
Yu Peng, Xiaojia Liu, Suyue Pan, Zuoshan Xie, Honghao Wang
Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis is a recently described paraneoplastic syndrome with prominent neuropsychiatric symptoms. Many of these cases are associated with neoplasma especially teratoma. In addition, a few of cases with anti-NMDAR antibodies triggered by viral infection have been reported, but never by parasitic infection. Here, we report a novel case of NMDA receptor encephalitis in a 51-year-old male related to the development of anti-NMDAR antibodies triggered by Angiostrongylus cantonensis infection...
October 24, 2016: Neurological Sciences
https://www.readbyqxmd.com/read/27776544/anti-n-methyl-d-aspartate-receptor-encephalitis-with-an-imaging-invisible-ovarian-teratoma-a-case-report
#11
Zainab M Abdul-Rahman, Peter K Panegyres, Margareta Roeck, David Hawkins, Jude Bharath, Paul Grolman, Cliffe Neppe, David Palmer
BACKGROUND: Anti-N-methyl-D-aspartate receptor encephalitis is a recently discovered disease entity of paraneoplastic limbic encephalitis. It largely affects young women and is often associated with an ovarian teratoma. It is a serious yet treatable condition if diagnosed early. Its remedy involves immunotherapy and surgical removal of the teratoma of the ovaries. This case of anti-N-methyl-D-aspartate receptor encephalitis involves an early surgical intervention with bilateral oophorectomy, despite negative imaging evidence of a teratoma...
October 24, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27758720/-autoimmune-encephalitis-due-to-mantle-cell-lymphoma
#12
A A H Bressers, N A Goto, S Piepers, J C Regelink
BACKGROUND: Autoimmune encephalitis is a rare condition characterized by subacute development of cognitive and psychiatric symptoms. A paraneoplastic syndrome involves autoimmune encephalitis caused by classic antibodies. Although this condition is often associated with cancer, no malignancy has yet been found in 70-90% of patients at the time of diagnosis. CASE DESCRIPTION: We saw a 58-year-old male patient with fatigue, diarrhoea and weight loss. He was also experiencing hyperekplexia, personality changes and an instable gait...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27737869/lgi1-encephalitis-a-disease-of-jerks-and-confusion
#13
Deepa Dash, Madhavi Tripathi, Kavish Ihtisham, Manjari Tripathi
Limbic encephalitis is a group of immune-mediated disorders that includes the classic paraneoplastic encephalitic syndrome and the recently described non-paraneoplastic autoimmune encephalitis most of which target the extracellular antigens. We present a case of 70-year-old man who presented with rapidly progressive cognitive decline and refractory faciobrachial dystonic seizures and demonstrated seropositivity for leucine-rich, glioma-inactivated protein 1 antibodies. After immunomodulation, the patient had dramatic improvement in the cognitive functioning and in seizure control...
October 13, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27673080/poster-326-paraneoplastic-ovarian-teratoma-anti-nmda-receptor-encephalitis-a-case-report
#14
Lauren A Kremm, Qianna Armstrong, Mary H Lawler
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/27667490/-autoimmune-encephalitis-associated-with-malignant-tumors
#15
Takashi Inuzuka
Autoimmune encephalitis consists of limbic symptoms and signs associated with antibodies against neuronal cell-surface antigens or intracellular antigens. Some cases are known to be associated with anti-channel or anti-receptor-related molecule antibodies. Whether these cases are paraneoplastic depends on the kinds of antigens that the antibodies are produced against. Other cases due to well-characterized onco-neural antibodies are almost always paraneoplastic and are generally resistant to anti-tumor therapy and/or immunotherapy...
September 2016: Brain and Nerve, Shinkei Kenkyū No Shinpo
https://www.readbyqxmd.com/read/27629954/paraneoplastic-limbic-encephalitis-in-a-human-epidermal-growth-factor-receptor-2-positive-gastric-cancer-patient-treated-with-trastuzumab-combined-chemotherapy-a-case-report-and-literature-review
#16
Yu Uneno, Akira Yokoyama, Yoshitaka Nishikawa, Taro Funakoshi, Yoshinao Ozaki, Ikuo Aoyama, Kiichiro Baba, Daisuke Yamaguchi, Shuko Morita, Yukiko Mori, Masashi Kanai, Hisanori Kinoshita, Takeshi Inoue, Nobukatsu Sawamoto, Riki Matsumoto, Shigemi Matsumoto, Manabu Muto
Paraneoplastic neurological syndromes (PNSs) are rare nervous system dysfunctions in cancer patients, which are primarily observed with small-cell lung cancer, gynecological cancer, and thymoma. We herein present an uncommon case of PNS in an anti-Hu antibody-positive patient with human epidermal growth factor receptor (HER)-2-positive gastric cancer (GC), who developed limbic encephalitis and a worsening cognitive function. Trastuzumab-combined chemotherapy was initiated and appeared to be partially effective for controlling the neurological symptoms and tumor volume...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27610299/successful-management-of-dexmedetomidine-for-postoperative-intensive-care-sedation-in-a-patient-with-anti-nmda-receptor-encephalitis-a-case-report-and-animal-experiment
#17
Daiki Yamanaka, Takashi Kawano, Hiroki Tateiwa, Hideki Iwata, Fabricio M Locatelli, Masataka Yokoyama
BACKGROUND: Anti-N-methyl-d-aspartate receptor (NMDA-R) encephalitis is a recently identified but increasingly recognized autoimmune paraneoplastic disease. Because these patients present complex neuropsychiatric symptoms due to NMDA-R dysfunction, the optimal methods of sedation/anesthesia remain controversial. Here, we present animal experiment data, along with a related case report, implying the safe and effective use of dexmedetomidine in patients with anti-NMDA-R encephalitis. FINDINGS: (1) Animal experiment: in order to investigate whether dexmedetomidine may interfere with NMDA-R activity, an NMDA antagonist (MK-801) model in rats was used to simulate anti-NMDA-R encephalitis...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27593992/how-far-to-investigate-presumed-psychosomatic-symptoms-lessons-from-a-particular-case%C3%A2
#18
Marie Angélique De Scheerder, Sylvie Rottey, An Mariman, Marleen Praet, Dirk Vogelaers
We describe a 43-year-old patient with subacute appearance of neurological and atypical complaints of anergia, anorexia and weight loss six months earlier. In spite of several admissions in different hospitals, no underlying somatic cause could be found and he was admitted to a psychiatric hospital with a tentative diagnosis of major depressive disorder. Subsequently, he was referred to the unit of medically unexplained physical symptoms within the department of general internal medicine for assessment by the psychiatrist, involved in this programme...
September 2, 2016: Acta Clinica Belgica
https://www.readbyqxmd.com/read/27592059/autoimmune-neurological-syndromes-associated-limbic-encephalitis-and-paraneoplastic-cerebellar-degeneration
#19
Zeynep Özözen Ayas, Dilcan Kotan, Yeşim Güzey Aras
INTRODUCTION: Autoimmune neurological syndrome is a group of disorders caused by cancer affecting nervous system by different immunological mechanisms. In this study, we aim to study the clinical symptoms, cerebrospinal fluid (CSF) findings, autoantibody tests, computed tomography (CT), magnetic resonance imaging (MRI) signs and treatment outcome of patients with autoimmune syndromes. METHODS: In this study, 7 patients (4 male, 3 female) diagnosed with autoimmune neurological syndrome were retrospectively examined...
October 6, 2016: Neuroscience Letters
https://www.readbyqxmd.com/read/27590992/anti-n-methyl-d-aspartate-receptor-encephalitis-a-potential-mimic-of-neuroleptic-malignant-syndrome
#20
Margaret Rozier, Denise Morita, Marta King
BACKGROUND: Anti-N-methyl-D-aspartate receptor encephalitis is an autoimmune disorder characterized by behavioral changes, dyskinesia, and autonomic instability. PATIENT DESCRIPTION: We describe a 14-year-old girl who initially presented with acute behavioral changes and seizures and who over a 2-week period developed high fever, tachycardia, and elevated blood pressures. RESULTS: Because she received multiple medications including anticonvulsants and a neuroleptic, our patient was initially diagnosed with neuroleptic malignant syndrome, a disorder characterized by autonomic dysfunction, hyperthermia, muscle rigidity, and mental status changes usually caused by the use of a neuroleptic agent...
October 2016: Pediatric Neurology
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