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Paraneoplastic limbic encephalitis resembling acute herpetic encephalitis.

Ioannis Markakis¹, Athanasios Papathanasiou², Ermioni Papageorgiou¹

¹Department of Neurology, "St. Panteleimon" General State Hospital of Piraeus, 18454 Nikaia, Greece.

Case Reports in Neurological Medicine

|December 31, 2013

Summary

Paraneoplastic limbic encephalitis (PLE) can mimic acute herpetic encephalitis. Early diagnosis is crucial for effective treatment and improved neurological outcomes in patients with this rare disorder.

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Area of Science:

Neurology
Oncology
Immunology

Background:

Paraneoplastic limbic encephalitis (PLE) is a rare autoimmune disorder.
PLE typically presents with chronic or subacute neurological symptoms.
Distinguishing PLE from other conditions like herpetic encephalitis can be challenging.

Purpose of the Study:

To present a case of PLE initially misdiagnosed as acute herpetic encephalitis.
To highlight the importance of considering PLE in the differential diagnosis of acute encephalitis.
To illustrate the diagnostic challenges and successful treatment of PLE.

Main Methods:

Case report of a 56-year-old male with acute neurological symptoms.
Diagnostic procedures included CSF analysis, cranial MRI, and CT scan.
Detection of anti-Hu antibodies and biopsy of a lymph node mass.

Main Results:

The patient presented with symptoms mimicking acute herpetic encephalitis.
Despite initial treatment, the patient's condition deteriorated.
Diagnosis of PLE secondary to neuroendocrine lung cancer was confirmed.
Treatment with steroids, chemotherapy, and tumor removal led to remission and neurological improvement.

Conclusions:

PLE can present acutely, mimicking infectious encephalitis.
Considering PLE in the differential diagnosis of acute encephalitis is clinically significant.
Prompt diagnosis and multimodal treatment can lead to favorable outcomes in PLE.