Table I.
Clinical features of paraneoplastic limbic encephalitis.
| Patient no. (ref.) | Gender, age in years | Tumor type/location | Symptoms and signs | EEG | CSF protein (mg/day) | Brain MRI and 18F-FDG/PET-CT | Neuronal antibodies | Prognosis |
|---|---|---|---|---|---|---|---|---|
| 1 (present study) | M, 69 | SCLC | Disorientation and GTCS for 90 days, Na+ 115 mmol/l | Bilateral frontal slow wave, right temporal lobe focal sharp-wave | Normal | Brain MRI: Atrophy in the bilateral temporal lobe and hippocampal area | Anti-Hu+ | Mortality |
| 2 (present study) | M, 83 | SCLC | Progressive short-term memory loss, partial complex seizure Na+ 130 mmol/l | Bilateral frontal, right temporal lobe slow wave | Normal | MRI: High signal intensity on the flair and T2-weighted image in the bilateral amygdala and hippocampal area | Anti-amphiphysin+ | Mortality |
| 3 (31) | M, 49 | Pancreatic cancer | Clumsy, apathy, echoing speech, memory loss, partial complex seizure; sucking, groping and grasping reflexes and a diffuse, brisk, deep tendon reflex; disorganization | Bilateral frontal, right temporal lobe, focal slow wave | Protein: 900 mg/l | MRI: Bilateral frontal lobe, temporal lobe, left parietal lobe, occipital lobe, cerebellar hemisphere, right parietal lobe. PET-CT: Bilateral frontal temporal lobe, right parietal lobe, occipital lobe, decreased metabolism | Negative | Mortality |
| 4 (33) | F, 22 | Ovarian teratoma | Apathy, babbing, conscious disturbance, GTCS status, Na+ 130 mmol/l | Bilateral diffuse slow wave | WBC: 16×106/l Protein: 50 mg/l |
Brain MRI: Normal | Negative | Recovery |
| 5 (30) | F, 17 | Ovarian teratoma | Short-term memory loss, emotional disturbance, GTCS status | Bilateral diffuse height amplitude δ waves | Intracranial hypertension, 220 mm H2O; WBC: 16×106/l, Protein: 580 mg/l | Brain MRI: Normal | NMDAR+ | Recovery |
| 6 (32) | M, 52 | SCLC | Short-term memory loss, partial complex seizure, Lambert-Eaton syndrome | - | - | MRI: Brain atrophy | Negative | Mortality |
Ref., reference number; EEG, electroencephalography; CSF, cerebrospinal fluid; MRI, magnetic resonance imaging; 18F-FDG/PET-CT, 18F-fluorodeoxygluocose/positron emission tomography-computed tomography; SLCL, small cell lung cancer; GTCS, generalized tonic-clonic seizure; WBC, white blood cells; NMDAR, N-methyl-D-aspartate receptor.