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Epilepsy boards > Autoimmune / neuro-oncology > Flashcards

Autoimmune / neuro-oncology Flashcards

1
Q

Auto-antibodies: VGKC Complex
- Symptoms: 4
- Associated cancers: (2)

A

Symptoms
- Personality or behavioral changes
- CJD like myoclonus
- neuropathy
- hyponatremia
Associated cancers
- SCLC
- Thymoma

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2
Q

Auto-antibodies: NMDA receptor
- Symptoms (3)
- Associated cancers: (1)

A

Symptoms
- psychosis
- Extrapyramida disorders (choreoathetosis)
- dysautonomia
Associated cancers
- Ovrian teratoma

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3
Q

Auto-antibodies: GAD
- Symptoms: (5)
- Associated cancers:

A

Symptoms:
- Stiff person syndrome
- ataxia
- brainstem encephalitis
- parkinsonism
- Type 1 DM)
Associated cancers
- Breast
- Thymoma
- Adenocarcinoma

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4
Q

Auto-antibodies: Ma1 and Ma2
- Symptoms
- Associated cancers:

A

Symptoms:
- brainstem encephalitis
Associated cancer
- Testicular

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5
Q

Auto-antibodies: Anna-1 (hu)
- Symptoms: (3)
- Associated cancers: (1)

A

Symptoms
- brainstem encephalitis
- autonomic neuropathy
- Sensory neuropathy
Associated cancer
- SCLC

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6
Q

Auto-antibodies: CRMP-5
- Symptoms: (5)
- Associated cancers: (2)

A

Symptoms:
- Dementia
- personality change
- chorea
- ataxia
- neuropathy
Associated Cancers
- SCLC
- Thymoma

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7
Q

Auto-antibodies: Amphiphysin
- Symptoms (3)
- Associated cancers: (2)

A

symptoms
- Dementia
- myelopathy
- Neuropathy
Associated cancers
- SCLC
- Breast adenocarcinoma

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8
Q

Auto-antibodies: GABA receptor
- Symptoms (1)
- Associated cancers: (2)

A

Symptoms
- Encephalopathy
Associated cacners
- SCLC
- Thymoma

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9
Q

Auto-antibodies: ANNA-2 (ri)
- Symptoms: (2)
- Associated cancers: (3)

A

Symptoms:
- brainstem encephalitis
- Cerebellar ataxia
Associated cancers
- SCLC
- Breast
- gynecological

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10
Q

Auto-antibodies: AMPA receptor
- Symptoms: (1)
- Associated cancers: (1)

A

Symptoms:
- psychiatric
Associated conditions:
- multiple solid cancers

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11
Q

MRI abnormalities seen with VGKC autoimmune epilepsy (3)

A

Bitemporal changes
- T2 hyperintensity
- Restricted diffusion
- Contrast enhancement

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12
Q

Patient presents with repetitive brief episodes of facial arm twitching and ipsilateral arm dystonia

What autoimmune epilepsy should you rule out

A

LGI-1
(Faciobrachial dystonic seizure)

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13
Q

Treatment for Anti-NMDA encephalitis

A

Step 1: diagnosis
* MRI
* EEG
* CSF antibody testing
* Cancer screening (ovarian teratoma)
Step 2: early immunotherapy
* 3-5-daysmethylpred and/or IVIG
If responsive, can transition to mycophenolate or azathioprine
If not responding, Cyclophosphamide or rituximab
Step 3: concomitant AED treatment
Step 4: management of systemic complicattions

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14
Q
A

left temporal glioblastoma multiforme

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15
Q

in adult brain tumors, which features are associated with higher rate of seizures? (2)

A

Near irritable structures / networks (limbic pathways, motor cortex)
LOW-grade tumors

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16
Q
  • Lab value also seen with VGKC-complex- mediated autoimmune seizures
  • Common receptor target
A

Hyponatremia
LGI1

17
Q

Seizure prophylaxis following tumor resection

A

One week pre-operative (even if no prior seizure history)

18
Q

Anti-amphiphysin
Associated cancers (2)
other symptoms

A

Associated cancers
- Small cell lung cancer
- Breast adenocarcinoma
Other symptom
- Nueropathy

19
Q

Name the likely brain tumor:
- Isointense on T1 and T2
- homogenous contrast enhancement
- extra axial
- dural tail
- CSF cleft sign

A

Meningioma

20
Q

Name the likely brain tumor:
- Cyst with enhancing mural nodule + calcifications:
- Supratentorial mural nodule:
- Mural nodule + peritumoral edema:

A
  • mural nodule + Calcifications: Ganglioglioma
  • supratentorial mural nodule - Pleiomorphic xantroastrocytoma (PXA)
  • Mural nodule + peritumoral edema: PXA
21
Q

Name the likely brain tumor:
- Bubbly cystic appearance
- Hyperintense T2 cysts within tumor
- wedged shape mass expanding gyri
- swollen gyrus

A

DNET

22
Q

Name the likely brain tumor:
- Hypointense on T1
- Hyperintense on T2
- Calcifications + blooming

A

Oligodendroglioma

23
Q

Name the likely brain tumor:
- nonenhancing non-neoplastic grey matter heterotopia
- usually in region of tuber cinereum

A

Hypothalamic Hammartoma

24
Q

Name the likely brain tumor:
- heterogeneous mass near Foramen of monroe
- Trasnsmantle sign
- cystic, bandplike lesiosn in white matter and radial bands

A

Subependymal giant cell astrocytoma (SEGA)

25
Q

What sequence?
What is it?
How do you know?

A
  • T2 showing left superior = - Left frontal DNET
  • bubbly appearance
  • Bright on T2
26
Q

What Sequence?
What is it?
How do you know?

A
27
Q

What sequence?
What is this?
How do you know (3)

A
  • (Pre-post contrast T-1)
  • meningioma
    How you know
  • Contrast-enhancing
  • Isointense Grey matter
  • Dural tail
28
Q

What sequences?
What is it?
How do you know?

A
  • Coronal T2, Sagittal T1
  • Hypothlamic hammartoma
    How you know:
  • ectopic gray matter along 3rd ventricular wall
29
Q

What sequences (4)
What do you see? (4)
What does this suggest?

A

Sequences:
- Axial T2
- SWI
- Pre and post contrast T1
What you see
- Popcorn-like T2 bright lesion
- surrounds hypointense susceptibility
- Contrast shows developmental venous anomaly.
This suggests: Cavernoma

30
Q

What does this show?
What does it suggest?

A
  • Right mesial frontal AVM with contrast enhancement
31
Q

What is this showing over time?
What does it suggest?

A

Shows:
- volume loss
- denudation of overlying cortex
Indicative of autoimmune encephalitis

32
Q

Tumors associated with NF1 (3)

A
  • optic glioma
  • peripheral / cranial nerve sheath tumors
  • astrocytomas
33
Q

Tumors associated with NF2

A
  • vestibular schqannomas
  • meningiomas
  • Schwannomas/neurilemmomas of dorsal roots of spinal cordT
34
Q

Buzzwords for Sturge-Weber Syndrome

A

Leptomingeal angiomatoses
“tram-track” calcification

35
Q

What is this showing?
What does this patient have?

A
  • T2 hyperintense cortical tubers (tuberous sclerosis)
36
Q

What is this showing?
What does the patient have?

A
  • CT showing tram-track calcification with Sturge Weber Syndrome
37
Q
A
38
Q

EEGs and brain tumors:
what could these EEG findings suggest:
- Very slow delta-range activity
- Arrythmic theta-range activity + discharges:
- Generalized slowing (2)
- Rhythmic delta (2)

A
  • Very slow delta-range activity: rapidly growing tumors
  • arryhtmic theta-range activiity with intermixed discharges: slowly growing tumors
  • Generalized slowing: midbrain tumors and
    large tumors of thalamus
  • Rhythmic delta: tumors invovling thalamus or deep frontal white matter

Epilepsy boards (23 decks)

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