Lee Kwan S, Higgins Michaela J, Patel Bhavesh M, Larson Joel S, Rady Mohamed Y
Department of Critical Care, Mayo Clinic, Scottsdale, AZ 85054, USA.
Neurocrit Care. 2006;4(2):137-9. doi: 10.1385/NCC:4:2:137.
Paraneoplastic neurological disorders are a well recognized complication of malignancy.
A case report to expand the currently described clinical manifestations of type 1 antineuronal antibody (ANNA-1)-associated paraneoplastic encephalomyelitis to include coma.
We present an unusual case of fluctuating coma and rapid fulminant progression to acute respiratory failure from central alveolar hypoventilation caused by ANNA-1 paraneoplastic encephalomyelitis associated with small-cell lung carcinoma. Paraneoplastic infiltration of the brainstem and cerebellum, including respiratory and arousal centers, was documented on autopsy.
Paraneoplastic encephalomyelitis should be considered as a possible cause of coma and central alveolar hypoventilation.
副肿瘤性神经系统疾病是一种公认的恶性肿瘤并发症。
通过一例病例报告来扩展目前所描述的1型抗神经元抗体（ANNA-1）相关副肿瘤性脑脊髓炎的临床表现，以纳入昏迷症状。
我们报告了一例不寻常的病例，该病例表现为昏迷状态波动，并迅速急剧进展为急性呼吸衰竭，其原因是与小细胞肺癌相关的ANNA-1副肿瘤性脑脊髓炎导致的中枢性肺泡低通气。尸检记录显示脑干和小脑存在副肿瘤浸润，包括呼吸和觉醒中枢。
副肿瘤性脑脊髓炎应被视为昏迷和中枢性肺泡低通气的可能病因。
