Omar Karray1, Sven Tolner2, Naïm Yarak3, Maguy Cherfan4, Mihaela Dana Cosma4, Walid Sleiman3, Philippe Niclot2, Jean Louis Dubost5, Patrick Coloby3, Stéphane Bart3. 1. Urology Department, René Dubos Hospital, 6, Avenue de l'Ile-de-France, 95300, Pontoise, France. omar.karray@ght-novo.fr. 2. Neurology Department, René Dubos Hospital, Pontoise, France. 3. Urology Department, René Dubos Hospital, 6, Avenue de l'Ile-de-France, 95300, Pontoise, France. 4. Pathology Department, René Dubos Hospital, Pontoise, France. 5. Intensive Care Unit, René Dubos Hospital, Pontoise, France.
Abstract
INTRODUCTION: 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. CLINICAL CASE: 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. CONCLUSION: 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.
INTRODUCTION: 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. CLINICAL CASE: 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. CONCLUSION: 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.