奥菲莉亚综合征：伴边缘性脑炎的霍奇金淋巴瘤。
Ophelia syndrome: Hodgkin lymphoma with limbic encephalitis.
作者信息
Juneja Monica, Kaur Satnam, Mishra Devendra, Jain Silky
机构信息
Department of Pediatrics, Maulana Azad Medical College and associated Lok Nayak hospital; and *Department of Pediatric Hemato-Oncology, Rajiv Gandhi Cancer Institute and Research Centre, Rohini; New Delhi, India. Correspondence to: Dr Satnam Kaur, Assistant Professor, Department of Pediatrics, Maulana Azad Medical College and associated Lok Nayak Hospital, New Delhi 110 002, India.
出版信息
Indian Pediatr. 2015 Apr;52(4):335-6.
BACKGROUND
Limbic encephalitis, an immune-mediated encephalitis, results from inflammation in the medial temporal lobes. The paraneoplastic form is rare in pediatric population, and frequently precedes tumor diagnosis.
CASE CHARACTERISTICS
A 9-year-old boy receiving chemotherapy for Hodgkin lymphoma, developed headache, temporal lobe seizures, anxiety, hallucinations, short-term memory loss and autonomic disturbances. Magnetic resonance imaging of brain showed features suggestive of limbic encephalitis. Electro-encephalography showed diffuse slowing with no epileptiform discharges.
OUTCOME
We diagnosed paraneoplastic form of limbic encephalitis. Treatment with steroids and intravenous immunoglobulin failed, and the child died 4 weeks after onset of symptoms.
MESSAGE
Limbic encephalitis should be kept as differential diagnosis in a child with sub-acutely evolving neuropsychiatric symptoms.
背景
边缘叶脑炎是一种免疫介导性脑炎，由内侧颞叶炎症引起。副肿瘤性边缘叶脑炎在儿科人群中罕见，且常先于肿瘤诊断出现。
病例特征
一名9岁男孩因霍奇金淋巴瘤接受化疗，出现头痛、颞叶癫痫发作、焦虑、幻觉、短期记忆丧失及自主神经功能紊乱。脑部磁共振成像显示有边缘叶脑炎的特征。脑电图显示弥漫性减慢，无癫痫样放电。
结果
我们诊断为副肿瘤性边缘叶脑炎。使用类固醇和静脉注射免疫球蛋白治疗无效，患儿在症状出现4周后死亡。
启示
对于有亚急性进展性神经精神症状的儿童，应将边缘叶脑炎作为鉴别诊断之一。
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