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Paraneoplastic AND cerebral AND brain

Makoto Shibata, Megumi Uchida, Setsuki Tsukagoshi, Koichi Yamaguchi, Aya Yamaguchi, Natsumi Furuta, Kouki Makioka, Toshitaka Maeno, Yukio Fujita, Masahiko Kurabayashi, Yoshio Ikeda
A 64-year-old Japanese woman presented with a three-month history of progressive numbness and weakness of the lower extremities. A neurological examination and nerve conduction study indicated sensorimotor polyneuropathy. Since the serum anti-Hu antibody titer was remarkably elevated, paraneoplastic neurological syndrome was highly suspected. A thoracoscopic biopsy of the hilar lymph nodes, in which (18)F-fluorodeoxyglucose uptake was obviously increased, revealed pathological findings for small-cell lung cancer (SCLC)...
2015: Internal Medicine
Masato Aragaki, Yasuaki Iimura, Kenichi Teramoto, Nagato Sato, Kazuyuki Hirose, Naoto Hasegawa
Here we a report a rare case of extralimbic encephalitis associated with thymoma. A 66-year-old woman was admitted to our hospital with cramping in her right leg and inability to walk. Magnetic resonance imaging of the brain showed multifocal high intensity signals on T2 flare images in the cerebral cortex, and chest computed tomography showed a 5-cm anterior mediastinal mass, which was considered to be a thymoma. We speculated that she had paraneoplastic encephalitis associated with thymoma. She underwent a thymectomy and was diagnosed with type B1 thymoma...
2015: Annals of Thoracic and Cardiovascular Surgery
Christopher Dardis, Thandar Aung, William Shapiro, John Fortune, Stephen Coons
We report a case of Langerhans cell histiocytosis in a 64-year-old male who presented with symptoms and signs of brain involvement, including seizures and hypopituitarism. The diagnosis was confirmed with a biopsy of a lytic skull lesion. The disease affecting the bone showed no sign of progression following a short course of cladribine. Signs of temporal lobe involvement led to an additional biopsy, which showed signs of nonspecific neurodegeneration and which triggered status epilepticus. Lesions noted in the brainstem were typical for the paraneoplastic inflammation reported in this condition...
January 2015: Case Reports in Neurology
Mayu Saho, Asuka Ito, Teruyuki Hiraki, Kazuo Ushijima
Trousseau's syndrome, a complex paraneoplastic disease, is characterized by the occurrence of thromboembolic disorders such as brain infarctions in patients with malignant neoplasms. We report the case of a 46-year-old woman with ovarian cancer who had suffered cerebral infarctions and presented with left hemiplegia, aphasia, and atypical genital bleeding. She suffered multiple right brain infarctions, a pulmonary embolism, a right renal infarction with bilateral hydronephrosis and deep venous thromboses and exhibited increased D-dimer and fibrinogen levels and so was administered heparin (10,000 U x day(-1))...
November 2014: Masui. the Japanese Journal of Anesthesiology
Ameer Rasheed, Viswanath Vasudevan, Qammar Abbas
Cancer Case Report Posters IISESSION TYPE: Affiliate Case Report PosterPRESENTED ON: Tuesday, October 28, 2014 at 01:30 PM - 02:30 PMINTRODUCTION: Non-small cell lung cancer (NSCLC) is the leading cause of mortality. It usually presents as lung mass with early metastasis. Central nervous system metastases presents as single ring enhanced lesion, causing seizures, focal deficits and headaches. We report a unique case of NSCLC without any evident lung mass presenting as gradual memory decline in otherwise healthy young female...
October 1, 2014: Chest
Atsushi Saito, Wenting Jia, Tatsuya Sasaki, Hiroki Mizukami, Akira Sasaki, Hideichi Shinkawa, Michiharu Nishijima
Cerebral venous thrombosis as a manifestation of paraneoplastic angitis and otitis media, revealing non-Hodgkin B-cell lymphoma (NHBL), is extremely rare. A 57-year-old woman presented with headache, auditory disturbance and recalcitrant otitis media. Magnetic resonance imaging showed brain edema in the temporal lobe and transverse sinus thrombosis. External drainage under antibiotic treatment was repeated based on a diagnosis of invasive otitis media and mastoiditis associated with infectious sinus thrombosis, but the condition deteriorated progressively...
May 2014: Case Reports in Neurology
S Sarria-Estrada, M Toledo, C Lorenzo-Bosquet, G Cuberas-Borrós, C Auger, S Siurana, A Rovira
AIM: To describe the characteristic magnetic resonance imaging (MRI) findings of paraneoplastic autoimmune encephalitis in patients with new-onset status epilepticus. MATERIALS AND METHODS: The neuroimaging and clinical data of five patients with paraneoplastic autoimmune encephalitis debuting as status epilepticus were retrospectively reviewed. All patients met the criteria for definite paraneoplastic syndrome and all underwent brain MRI during the status epilepticus episode or immediately after recovery...
August 2014: Clinical Radiology
Monique K Lewis, Jill T Jamison, Joseph C Dunbar, Donald J DeGracia
Translation arrest occurs in neurons following focal cerebral ischemia and is irreversible in penumbral neurons destined to die. Following global cerebral ischemia, mRNA is sequestered away from 40S ribosomal subunits as mRNA granules, precluding translation. Here, we investigated mRNA granule formation using fluorescence in situ histochemistry out to 8 h permanent focal cerebral ischemia using middle cerebral artery occlusion in Long Evans rats with and without diabetes. Neuronal mRNA granules colocalized with PABP, HuR, and NeuN, but not 40S or 60S ribosomal subunits, or organelle markers...
December 2013: Translational Stroke Research
Jeffrey J Szymanski, Haihui Wang, Jill T Jamison, Donald J DeGracia
Prolonged translation arrest in post-ischemic hippocampal CA1 pyramidal neurons precludes translation of induced stress genes and directly correlates with cell death. We evaluated the regulation of mRNAs containing adenine- and uridine-rich elements (ARE) by assessing HuR protein and hsp70 mRNA nuclear translocation, HuR polysome binding, and translation state analysis of CA1 and CA3 at 8 h of reperfusion after 10 min of global cerebral ischemia. There was no difference between CA1 and CA3 at 8 h of reperfusion in nuclear or cytoplasmic HuR protein or hsp70 mRNA, or HuR polysome association, suggesting that neither mechanism contributed to post-ischemic outcome...
December 2013: Translational Stroke Research
Sarmad Said, Chad J Cooper, Edgar Reyna, Haider Alkhateeb, Jesus Diaz, Zeina Nahleh
PATIENT: Female, 59 FINAL DIAGNOSIS: Paraneoplastic limbic encephalitis Symptoms: Seizure • memory changes • decreased concentration MEDICATION: Chemotherapy Clinical Procedure: Cerebral images Specialty: Hematology • Oncology. OBJECTIVE: Challenging differential diagnosis. BACKGROUND: Paraneoplastic neurological disorders (PND) are defined as remote effects on the nervous system that are not caused directly by the tumor, its metastases, or metabolic disruptions...
2013: American Journal of Case Reports
Peter W Kaplan, Raoul Sutter
There is an increasing recognition of autoimmune limbic encephalopathy with the hope for earlier diagnosis and expedited and improved treatment. Although antibody testing remains the definitive clinical diagnostic feature, the presentation of a rapid dementia, behavioral changes, and seizures leads to investigation using cerebral imaging, electroencephalography, and cerebrospinal fluid to confirm the diagnosis and also to exclude similar disorders. The electroencephalographer may be asked to comment on the types of electroencephalography abnormality and provide input toward the diagnosis of limbic encephalopathy...
October 2013: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
Peter W Kaplan, Raoul Sutter
Patients with acute confusional states (often referred to as encephalopathy or delirium) pose diagnostic and management challenges for treating physicians. Encephalopathy is associated with a high morbidity and mortality rate, and the diagnosis rests on clinical grounds but may also be supported by the finding of electroencephalographic (EEG) evidence for diffuse cerebral dysfunction. The myriad cerebral transmitter and metabolic disruptions are generated by systemic organ system failures, principal among which are those of the liver, kidneys, lungs, heart, and endocrine system, along with the effects of exogenous toxins and medications...
October 2013: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
Katrina Peariso, Shannon M Standridge, Barbara E Hallinan, James L Leach, Lili Miles, Francesco T Mangano, Hansel M Greiner
AIM: To describe the clinical course and pathological diagnosis of a 12-year-old female who presented with an acute syndrome of right hemispheric epilepsy and cortical dysfunction and brain MRI demonstrating atrophy of the left cerebral and right cerebellar hemispheres. RESULTS: The patient presented with occasional partial seizures consisting of a left calf sensation followed by left leg clonic jerking. Initial brain MRI showed left cerebral and right cerebellar atrophy with T2 hyperintensity in the left parietal region...
September 2013: Epileptic Disorders: International Epilepsy Journal with Videotape
Annette Baumgartner, Sebastian Rauer, Irina Mader, Philipp T Meyer
In parallel to the detection of new neuronal autoantibodies, the diagnosis of non-infectious limbic encephalitis has risen. Given that cerebral imaging studies show highly variable results, the present retrospective study investigates imaging findings in association with autoantibody type. An institutional database search identified 18 patients with non-infectious limbic encephalitis who had undergone [18F] fluorodeoxyglucose positron emission tomography (FDG-PET). Sixteen of these patients also underwent magnetic resonance imaging (MRI)...
November 2013: Journal of Neurology
Andreas H Kramer
Viral encephalitis causes an altered level of consciousness, which may be associated with fever, seizures, focal deficits, CSF pleocytosis, and abnormal neuroimaging. Potential pathogens include HSV, VZV, enterovirus, and in some regions, arboviruses. Autoimmune (eg, anti-NMDA receptor) and paraneoplastic encephalitis are responsible for some cases where no pathogen is identified. Indications for ICU admission include coma, status epilepticus and respiratory failure. Timely initiation of anti-viral therapy is crucial while relevant molecular and serological test results are being performed...
July 2013: Critical Care Clinics
Christopher K Cheng, Keith A Siller
We report a patient who recently had a liver transplant presented with increasing confusion and intermittent hallucinations. MRI of the brain revealed diffuse left temporal and parietal lobe swelling with cortical diffusion restriction suggestive of possible infectious aetiology, although stroke was also possible given the presence of left posterior cerebral arteries with fetal origin in the anterior circulation. An EEG demonstrated subclinical seizures, for which he was placed on an antiepileptic medication...
2013: BMJ Case Reports
Allison J Clapp, Christopher H Hunt, Geoffrey B Johnson, Patrick J Peller
PURPOSE: The objective of this study was to evaluate brain metabolism with F-FDG-PET in patients with definite or possible paraneoplastic neurologic syndromes (PNS) using qualitative assessment and semiquantitative measurements with subsequent correlation with MRI. METHODS: The institutional review board approved this Health Insurance Portability and Accountability Act-compliant study. A prospective PET database of patients referred for PNS between 2001 and 2010 was queried retrospectively and identified 102 patients who met the diagnostic criteria for PNS, had PET brain imaging, and lacked clinical or MRI evidence of an alternative diagnosis...
April 2013: Clinical Nuclear Medicine
J Aupy, N Collongues, F Blanc, C Tranchant, E Hirsch, J De Seze
INTRODUCTION: Encephalitis is an inflammatory or infectious disease with an acute or subacute presentation. Immunological abnormalities in serum can be found but may be underdiagnosed. In several cases, a paraneoplastic origin with anti-neuron antibodies is noted. In all cases, other auto-antibodies can be found with or without any neoplastic mechanism. OBJECTIVES: The aim of our study was to describe a clinical, radiological and immunological cohort of patients with autoimmune encephalitis and suggest a diagnostic and therapeutic algorithm...
February 2013: Revue Neurologique
Auxane Buresi, Ester Canali, Laure Bonnaud, Sébastien Baratte
Among the Lophotrochozoa, centralization of the nervous system reaches an exceptional level of complexity in cephalopods, where the typical molluscan ganglia become highly developed and fuse into hierarchized lobes. It is known that ganglionic primordia initially emerge early and simultaneously during cephalopod embryogenesis but no data exist on the process of neuron differentiation in this group. We searched for members of the elav/hu family in the cuttlefish Sepia officinalis, since they are one of the first genetic markers of postmitotic neural cells...
May 1, 2013: Journal of Comparative Neurology
Christian G Bien, Angela Vincent, Michael H Barnett, Albert J Becker, Ingmar Blümcke, Francesc Graus, Kurt A Jellinger, David E Reuss, Teresa Ribalta, Jürgen Schlegel, Ian Sutton, Hans Lassmann, Jan Bauer
Classical paraneoplastic encephalitis syndromes with 'onconeural' antibodies directed to intracellular antigens, and the recently described paraneoplastic or non-paraneoplastic encephalitides and antibodies against both neural surface antigens (voltage-gated potassium channel-complexes, N-methyl-d-aspartate receptors) and intracellular antigens (glutamic acid decarboxylase-65), constitute an increasingly recognized group of immune-mediated brain diseases. Evidence for specific immune mechanisms, however, is scarce...
May 2012: Brain: a Journal of Neurology
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