Naslov
Paraneoplastic limbic encephalitis in patient with adenocarcinoma of the colon

Autori
Nesek Adam, Višnja ; Budinčević, Hrvoje ; Mršić, Viviana ; Grizelj Stojčić, Elvira ; Matolić, Marina ; Šakić, Katarina

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, stručni

Izvornik
The European Anaesthesiology Congress European Euroanaeshesia 2012 : abstracts ; u: Journal of Anaesthiology 26 (2012) (S) / - , 2012, 175-175

Skup
The European Anaesthesiology Congress Euroanaeshesia 2012

Mjesto i datum
Pariz, Francuska, 09.06.2012. - 12.06.2012

Vrsta sudjelovanja
Predavanje

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
paraneoplastic limbice encephalitis ; colon carcinoma

Sažetak
Paraneoplastic limbic encephalitis (PLE) is a rare disorder characterized by the development of neuropsychiatric symptoms associated with malignancies. A 61-year-old woman was admitted to the hospital because of abdominal pain and altered mental status. On admission, her temperature was 39.4°C, blood pressure was 140/80 mmHg, pulse rate 110 beats/min, and she had extremely high blood glucose level of 44.9 mmol/. On physical examination, she was unresponsive to verbal stimuli, the abdomen was distended and had peritoneal signs. After stabilization and correction of the hyperglycemia the patient underwent emergency surgery. Laparotomy revealed marked dilatation with gangrenous changes affecting the colon and stenosing tumor in the sigmoid colon. After the operation the patient was transferred to the ICU for mechanical ventilation and remained ventilator dependent for 42 days. Most of the time she was febrile and despite various antibiotic treatment fewer persist with a peak of 40°C. Neurological examination showed somnolence state and left-sided hemiparesis. On MRI scanning hyperintensities in both hippocampal areas were seen. An EEG showed sharp-wave activity in temporal lobes Examination of the CSF revealed slightly elevated protein level and laboratory assessments showed an elevated titer of anti-YO antibodies. Forty two days after the onset of illness the patient remained somnolence and ventilator-dependent and was transferred to the Department of Medicine and Geriatrics for ventilator rehabilitation. Discussion: Although, we do not have pathological confirmation of limbic encephalitis in our patient, the diagnosis of paraneoplastic limbic encephalitis was presumed on the basis of MR imaging findings, EEG abnormality elevated of CSF protein, positive anti YO antibodies, combination of neurological symptoms and exclusion of other causes. The most patients usually start to gradually improve neurological status within 2 to 3 weeks of tumor removal but our case show that the recovery of some patient's colud be unexpected and patients may remain ventilated for several months in a somnolence state.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA