Autoimmune / neuro-oncology Flashcards
Auto-antibodies: VGKC Complex
- Symptoms: 4
- Associated cancers: (2)
Symptoms
- Personality or behavioral changes
- CJD like myoclonus
- neuropathy
- hyponatremia
Associated cancers
- SCLC
- Thymoma
Auto-antibodies: NMDA receptor
- Symptoms (3)
- Associated cancers: (1)
Symptoms
- psychosis
- Extrapyramida disorders (choreoathetosis)
- dysautonomia
Associated cancers
- Ovrian teratoma
Auto-antibodies: GAD
- Symptoms: (5)
- Associated cancers:
Symptoms:
- Stiff person syndrome
- ataxia
- brainstem encephalitis
- parkinsonism
- Type 1 DM)
Associated cancers
- Breast
- Thymoma
- Adenocarcinoma
Auto-antibodies: Ma1 and Ma2
- Symptoms
- Associated cancers:
Symptoms:
- brainstem encephalitis
Associated cancer
- Testicular
Auto-antibodies: Anna-1 (hu)
- Symptoms: (3)
- Associated cancers: (1)
Symptoms
- brainstem encephalitis
- autonomic neuropathy
- Sensory neuropathy
Associated cancer
- SCLC
Auto-antibodies: CRMP-5
- Symptoms: (5)
- Associated cancers: (2)
Symptoms:
- Dementia
- personality change
- chorea
- ataxia
- neuropathy
Associated Cancers
- SCLC
- Thymoma
Auto-antibodies: Amphiphysin
- Symptoms (3)
- Associated cancers: (2)
symptoms
- Dementia
- myelopathy
- Neuropathy
Associated cancers
- SCLC
- Breast adenocarcinoma
Auto-antibodies: GABA receptor
- Symptoms (1)
- Associated cancers: (2)
Symptoms
- Encephalopathy
Associated cacners
- SCLC
- Thymoma
Auto-antibodies: ANNA-2 (ri)
- Symptoms: (2)
- Associated cancers: (3)
Symptoms:
- brainstem encephalitis
- Cerebellar ataxia
Associated cancers
- SCLC
- Breast
- gynecological
Auto-antibodies: AMPA receptor
- Symptoms: (1)
- Associated cancers: (1)
Symptoms:
- psychiatric
Associated conditions:
- multiple solid cancers
MRI abnormalities seen with VGKC autoimmune epilepsy (3)
Bitemporal changes
- T2 hyperintensity
- Restricted diffusion
- Contrast enhancement
Patient presents with repetitive brief episodes of facial arm twitching and ipsilateral arm dystonia
What autoimmune epilepsy should you rule out
LGI-1
(Faciobrachial dystonic seizure)
Treatment for Anti-NMDA encephalitis
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
left temporal glioblastoma multiforme
in adult brain tumors, which features are associated with higher rate of seizures? (2)
Near irritable structures / networks (limbic pathways, motor cortex)
LOW-grade tumors