Karray Omar, Tolner Sven, Yarak Naïm, Cherfan Maguy, Cosma Mihaela Dana, Sleiman Walid, Niclot Philippe, Dubost Jean Louis, Coloby Patrick, Bart Stéphane
Urology Department, René Dubos Hospital, 6, Avenue de l'Ile-de-France, 95300, Pontoise, France.
Neurology Department, René Dubos Hospital, Pontoise, France.
J Med Case Rep. 2021 Jul 28;15(1):405. doi: 10.1186/s13256-021-02975-3.
Limbic encephalitis is an autoimmune neurologic disorder, often of paraneoplastic origin, that seldom complicates prostatic tumors. The nonspecificity of symptoms makes the diagnosis sometimes difficult to establish. Prognosis is essentially determined by comorbidities and sensorineural and cognitive sequelae.
A 66-year-old Caucasian patient known to have prostatic small-cell neuroendocrine adenocarcinoma under hormonal therapy developed complex partial epileptic seizures associated with rapidly aggravating severe memory impairment. The tripod of autoimmune limbic encephalitis diagnosis was based on the clinical aspect of brain's functional deterioration, electroencephalography aspect, and γ-aminobutyric acid type B anti-receptor antibody positivity. Clinical, diagnostic, and therapeutic management as well as evolutionary risks were further analyzed.
Limbic encephalitis is an extremely rare presentation of neurologic paraneoplastic syndromes. A better knowledge of this entity would help better manage diagnostic and therapeutic difficulties and reduce the risk of possible sequelae.
边缘叶脑炎是一种自身免疫性神经系统疾病,通常为副肿瘤性起源,很少并发前列腺肿瘤。症状的非特异性有时使得诊断难以确立。预后主要由合并症以及感觉神经和认知后遗症决定。
一名66岁的白种男性患者,已知患有前列腺小细胞神经内分泌腺癌且正在接受激素治疗,出现了复杂部分性癫痫发作,并伴有迅速加重的严重记忆障碍。自身免疫性边缘叶脑炎的诊断依据三个方面,即脑功能恶化的临床症状、脑电图表现以及γ-氨基丁酸B型抗受体抗体阳性。对临床、诊断、治疗管理以及病情发展风险进行了进一步分析。
边缘叶脑炎是神经副肿瘤综合征极为罕见的一种表现形式。对该疾病有更深入的了解将有助于更好地应对诊断和治疗难题,并降低可能出现后遗症的风险。