Rinsho Shinkeigaku (Clinical Neurology)

Case Report

Paraneoplastic anti-gamma aminobutyric acid (GABA)B receptor antibody limbic encephalitis associated with small cell lung cancer presenting as new-onset status epilepticus: a case report

Natsuki Akiyama, M.D.1), Yamato Miwa, M.D.1), Yoshitaka Umeda, M.D.1), Keiko Tanaka, M.D., Ph.D.2), Mutsuo Oyake, M.D., Ph.D.1) and Nobuya Fujita, M.D., Ph.D.1)

1) Department of Neurology, Nagaoka Red Cross Hospital
2) Department of Animal Model Development, Brain Research Institute, Niigata University

An 84-year-old man was admitted to our hospital with new-onset refractory status epilepticus of unclear etiology. On the third day, diffusion-weighted brain MRI demonstrated lesions in the right medial temporal and parietal lobes. As a CSF sample showed pleocytosis, paraneoplastic limbic encephalitis (PLE) associated with small cell lung cancer (SCLC) was suspected. The patient was also positive for anti-gamma aminobutyric acid (GABA)B receptor antibody in the CSF, which has recently been reported in elderly patients with SCLC-related PLE. Methylprednisolone pulse therapy ameliorated the symptoms. It is noteworthy that immune therapy often improves the symptoms of PLE with anti-GABAB receptor antibody, even though radical therapy for the lung cancer may be difficult.
Full Text of this Article in Japanese PDF (2092K)

(CLINICA NEUROL, 60: 869−873, 2020)
key words: anti-gamma aminobutyric acid (GABA)B receptor antibody, paraneoplastic limbic encephalitis, small cell lung cancer, epilepsy in the elderly, immunotherapy

(Received: 21-Jun-20)