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• Vol.52 No.9
• CLINICA NEUROL, 52: 666−671, 2012
• Vol.52 No.9 contents

Case Report

Anti-Ma2, anti-NMDA-receptor and anti-GluRε2 limbic encephalitis with testicular seminoma:
short-term memory disturbance

Akihiro Kubota, M.D.¹⁾, Takashi Tajima, M.D.¹⁾, Shinya Narukawa, M.D.¹⁾,Masamizu Yamazato, M.D.¹⁾, Hikoaki Fukaura, M.D.¹⁾, Yukitoshi Takahashi, M.D.²⁾, Keiko Tanaka, M.D.³⁾, Jun Shimizu, M.D.⁴⁾ and Kyoichi Nomura, M.D.¹⁾

¹⁾Department of Neurology, Saitama Medical Center, Saitama Medical University
²⁾National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders
³⁾Department of Neurology, Kanazawa Medical University
⁴⁾Department of Neurology, University of Tokyo, Graduate School of Medicine

A 36-year-old man presented with cognitive impairment and disturbance of short-term memory functions with character change. Cerebrospinal fluid analysis revealed no abnormalities; however, brain MRI revealed highsignal intensity from bilateral hippocampus lesions on fluid attenuated inversion recovery (FLAIR) images and T₂ weighted images. The 18F-fluorodeoxyglucose PET demonstrated high glucose uptake in the bilateral hippocampus lesions. He was diagnosed as limbic encephalitis, and was administered high-dose intravenous methylprednisolone and immune adsorption plasma therapy followed by intravenous immunoglobulin therapy. MRI abnormalities improved after treatment but recent memory disturbance remained. Ma2 antibody, NMDA-receptor antibody, and GluRε2 antibody were positive. Eleven months atter the onset of disease, the tumor was identified in left testicle by ultrasound and removed the tumor. The pathological findings were seminoma. We experienced a case of paraneoplastic limbic encephalitis associated with seminoma with short-term memory disturbance. The occurrence of paraneoplastic limbic encephalitis with antibodies against cell membrane (NMDA-receptor antibody and GluRε2 antibody) and intracellular (Ma2 antibody) is rare even in the literature.
Full Text of this Article in Japanese PDF (638K)

(CLINICA NEUROL, 52: 666−671, 2012)
key words: anti-Ma2 antibody, anti-N-methyl-D-aspartate receptor antibody, anti-glutamate receptor antibodies, shortterm memory, paraneoplastic syndromes

(Received: 2-Mar-12)