Autoimmune gabab antibody encephalitis associated with non-malignant lung lesion

GABAb receptor autoimmune encephalitis is a potentially treatable disorder characterised by seizures, memory deficits, increased anxiety and mood dysregulation. In some patients it is associated with small–cell lung cancer and with other autoantibodies. We are presenting a case of GABAb receptor autoimmune encephalitis which was associated with non–malignant lung lesion, likely inflammatory in nature. A 62 year old woman presented with recent onset depression and tonic–clonic seizures. CT head showed patchy white matter changes particularly in the left frontal lobe. Initial treatment for suspected infective encephalitis with ceftriaxone and acyclovir was withdrawn after normal results of CSF analysis and negative viral PCR. Ongoing seizures were treated with a combination of anticonvulsants. MRI brain showed an encephalitic process involving the temporal lobes (Figure 1) with corresponding change on PET scan. (Figure 2) PET also showed a small nodule in the right lung with a paratracheal lymph node (Figure 3). Diagnosis of paraneoplastic encephalitis secondary to a lung tumour was made during lung MDT. Interval scanning at two months showed an increase in size of the pretracheal lymph node. Testing for VGKC antibodies, anti–TPO, NMDAR antibodies was negative. However repeat scan at an interval of six months showed resolution of the chest changes. Patient clinically improved with treatment of the seizures but was left with significant cog...
Source: Journal of Neurology, Neurosurgery and Psychiatry - Category: Neurosurgery Authors: Tags: Immunology (including allergy), Epilepsy and seizures, Infection (neurology), Stroke, Drugs: psychiatry, Memory disorders (psychiatry), Radiology, Drugs: musculoskeletal and joint diseases, Radiology (diagnostics) Association of British Neurologists (AB Source Type: research