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01.12.2014 | Case report | Ausgabe 1/2014 Open Access

Journal of Medical Case Reports 1/2014

Small-cell lung cancer with voltage-gated calcium channel antibody-positive paraneoplastic limbic encephalitis: a case report

Zeitschrift:
Journal of Medical Case Reports > Ausgabe 1/2014
Autoren:
Kyoichi Kaira, Takashi Okamura, Hiroki Takahashi, Norio Horiguchi, Noriaki Sunaga, Takeshi Hisada, Masanobu Yamada
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1752-1947-8-119) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

KK and TO operated on the patient and were major contributors in making a conception, design, acquisition of data and drafting the manuscript or revising it critically for important intellectual content. HT and NH were contributors in making a conception, design and acquisition of data. NS and TH provided advice on patient management. MY made critical revisions to the manuscript. All authors read and approved the final manuscript.

Abstract

Introduction

Paraneoplastic limbic encephalitis is a rare neurological syndrome and clinically characterized by cognitive dysfunction, memory impairment, seizures and psychiatric symptoms. Paraneoplastic limbic encephalitis is most frequently found in small-cell lung cancer, among various malignancies, and antineuronal antibodies are related to the autoimmune mechanism. We experienced a rare case of a patient with small-cell lung cancer with anti-voltage-gated calcium channel antibody-positive paraneoplastic limbic encephalitis.

Case presentation

A 61-year-old Japanese man with a history of smoking cigarettes presented with seizure, confusion and personality change in acute onset. Brain magnetic resonance imaging showed high signal intensity on T2-weighted image in his right temporal lobe, suggestive of limbic encephalitis. A mediastinoscopy of the lymph node revealed small-cell lung carcinoma, and he was staged as having limited stage disease. Antibodies against P/Q-type and N-type voltage-gated calcium channel were positive and Hu antibody was negative. He was started on chemotherapy of carboplatin plus etoposide with concurrent thoracic radiotherapy. Neurological symptoms were gradually improved after systemic chemotherapy.

Conclusions

We should be alert to the potential of malignant neoplasms associated with paraneoplastic limbic encephalitis when we examine a patient with cancer with neurological disorders such as personality change, disorientation, unconsciousness and memory loss. A clinical marker such as voltage-gated calcium channel antibody may help our diagnosis in clinical practice.

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Zusatzmaterial
Authors’ original file for figure 1
13256_2013_2756_MOESM1_ESM.pdf
Authors’ original file for figure 2
13256_2013_2756_MOESM2_ESM.pdf
Authors’ original file for figure 3
13256_2013_2756_MOESM3_ESM.pptx
Authors’ original file for figure 4
13256_2013_2756_MOESM4_ESM.pptx
Literatur
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