Brainstem and limbic encephalitis with paraneoplastic neuromyelitis optica

Area of Science:

• Neurology
• Immunology
• Oncology

Background:

• The Neuromyelitis Optica Spectrum Disorders (NMOSD) are increasingly recognized autoimmune conditions.
• While NMOSD is typically idiopathic or associated with other autoimmune diseases, paraneoplastic associations are being identified.

Observation:

• A case of brainstem and limbic encephalitis is presented in a patient with NMO-immunoglobulin G (NMO-IgG) in serum and cerebrospinal fluid.
• The patient had a concurrent diagnosis of newly diagnosed breast cancer.

Findings:

• Neurological symptoms significantly improved following surgical excision of the breast cancer.
• Immunosuppressive therapy also contributed to the patient's recovery.

Implications:

• This case expands the known spectrum of NMOSD to include a paraneoplastic association with breast cancer.
• It highlights the importance of considering cancer screening in patients presenting with NMOSD, particularly when clinical features suggest a paraneoplastic origin.