Multifocal paraneoplastic cortical encephalitis associated with myasthenia gravis and thymoma

Khaled Hammoud, Geetha Kandimala, Worthy Warnack, Steven Vernino

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Objectives: To report a case of multifocal cortical encephalitis associated with thymoma and to establish an association of this thymoma-related paraneoplastic syndrome with voltage-gated potassium channel antibodies. Design: Case report. Setting: University hospital. Patient: A 43-year-old woman with a history of sero-positive myasthenia gravis and successfully treated invasive thymoma. Four years after thymectomy, she presented with seizure and rapidly progressive confusion and aphasia. Myasthenia gravis remained in pharmacological remission. Magnetic resonance imaging of the brain showed innumerable cortically based signal abnormalities as well as extensive left mesial temporal lobe abnormality with minimal enhancement. Results: Chest computed tomography showed abnormal pleural thickening of the left lung, which proved to be recurrent metastatic thymoma. Results of serological evaluation were positive for acetylcholine receptor, striational, and voltage-gated potassium channel antibodies. She showed partial improvement in response to immunotherapy and chemotherapy but ultimately died 2 months later of tumor complications. Conclusions: Thymoma and myasthenia gravis may be associated with other autoimmune neurological disorders including paraneoplastic encephalitis. This second case of thymoma-associated multifocal cortical encephalitis demonstrates that autoimmune encephalitis can extend to cortical regions outside the limbic system. Autoimmune encephalitis should be considered in the differential diagnosis of patients with myasthenia gravis or thymoma who develop new cognitive symptoms.

Original languageEnglish (US)
Pages (from-to)1407-1409
Number of pages3
JournalArchives of Neurology
Volume66
Issue number11
DOIs
StatePublished - Nov 2009

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Thymoma
Myasthenia Gravis
Encephalitis
Voltage-Gated Potassium Channels
Paraneoplastic Syndromes
Confusion
Limbic System
Thymectomy
Neurobehavioral Manifestations
Antibodies
Aphasia
Cholinergic Receptors
Temporal Lobe
Nervous System Diseases
Immunotherapy
Seizures
Differential Diagnosis
Thorax
Tomography
Magnetic Resonance Imaging

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Multifocal paraneoplastic cortical encephalitis associated with myasthenia gravis and thymoma. / Hammoud, Khaled; Kandimala, Geetha; Warnack, Worthy; Vernino, Steven.

In: Archives of Neurology, Vol. 66, No. 11, 11.2009, p. 1407-1409.

Research output: Contribution to journalArticle

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