Multifocal Paraneoplastic Cortical Encephalitis Associated With Myasthenia Gravis and Thymoma

Abstract

Objectives: To report a case of multifocal cortical encephalitis associated with thymoma and to establish an association of this thymoma-related paraneoplastic syndrome with voltage-gated potassium channel antibodies.

Paraneoplastic Extralimbic Encephalitis Associated with Thymoma: A Case Report

“…Two cases developed ELE during thymoma recurrence of thymectomy surgery (Okita and Hammond reported cases). 6,7) In five cases, including our case, neurological symptoms improved after treatment ( Table 1). In almost all cases that experienced postoperative favorable progress, with proven histological type, neurological symptoms improved during the early postoperative period.…”

Paraneoplastic Extralimbic Encephalitis Associated with Thymoma: A Case Report

“…Two cases developed ELE during thymoma recurrence of thymectomy surgery (Okita and Hammond reported cases). 6,7) In five cases, including our case, neurological symptoms improved after treatment ( Table 1). In almost all cases that experienced postoperative favorable progress, with proven histological type, neurological symptoms improved during the early postoperative period.…”

Recurrent Thymoma-Associated Paraneoplastic Encephalitis Resulting From Multiple Antibodies: A Case Report

“…Prior reports of multiple antibodies in thymoma-associated encephalitis are rare and usually in the context of fulminant symptoms. 14,15 We further emphasize the importance of testing for antibodies in both the CSF and serum in patients with suspected autoimmune encephalitis, since antibodies detected in the CSF are typically more diagnostic. Multiple antibodies can often be associated with worse outcomes, requiring aggressive immunosuppressive therapy after treating the underlying malignancy.…”

One Patient with 3 Antibody-Confirmed Neurological Autoimmune Syndromes: A Case Report and Review of the Literature

“…In 2023, Schäfer, Christensen, and Jensen [ 22 ] described a case of a previously healthy 24 year-old man who developed first seronegative MG and then a few months later encephalitis with antibodies against AMPA and NMDA receptors. Further, there are many reports of MG concurrent with other forms of encephalitis, including anti-AMPA receptor encephalitis [ 23 ] and paraneoplastic encephalitis [ 24 – 26 ]. Notably, one case described a patient with MG and leucine-rich glioma-inactivated 1 (LGI1) protein antibody-associated encephalitis, a condition known for psychiatric symptoms similar to NMDA encephalitis, along with its hallmark faciobrachial seizures [ 27 ].…”

Paraneoplastic Extralimbic Encephalitis Associated with Thymoma: A Case Report

“…Two cases developed ELE during thymoma recurrence of thymectomy surgery (Okita and Hammond reported cases). 6,7) In five cases, including our case, neurological symptoms improved after treatment ( Table 1). In almost all cases that experienced postoperative favorable progress, with proven histological type, neurological symptoms improved during the early postoperative period.…”

Recurrent Thymoma-Associated Paraneoplastic Encephalitis Resulting From Multiple Antibodies: A Case Report

“…Prior reports of multiple antibodies in thymoma-associated encephalitis are rare and usually in the context of fulminant symptoms. 14,15 We further emphasize the importance of testing for antibodies in both the CSF and serum in patients with suspected autoimmune encephalitis, since antibodies detected in the CSF are typically more diagnostic. Multiple antibodies can often be associated with worse outcomes, requiring aggressive immunosuppressive therapy after treating the underlying malignancy.…”

One Patient with 3 Antibody-Confirmed Neurological Autoimmune Syndromes: A Case Report and Review of the Literature

“…In 2023, Schäfer, Christensen, and Jensen [ 22 ] described a case of a previously healthy 24 year-old man who developed first seronegative MG and then a few months later encephalitis with antibodies against AMPA and NMDA receptors. Further, there are many reports of MG concurrent with other forms of encephalitis, including anti-AMPA receptor encephalitis [ 23 ] and paraneoplastic encephalitis [ 24 – 26 ]. Notably, one case described a patient with MG and leucine-rich glioma-inactivated 1 (LGI1) protein antibody-associated encephalitis, a condition known for psychiatric symptoms similar to NMDA encephalitis, along with its hallmark faciobrachial seizures [ 27 ].…”

Paraneoplastic Extralimbic Encephalitis Associated with Thymoma: A Case Report

“…Two cases developed ELE during thymoma recurrence of thymectomy surgery (Okita and Hammond reported cases). 6,7) In five cases, including our case, neurological symptoms improved after treatment ( Table 1). In almost all cases that experienced postoperative favorable progress, with proven histological type, neurological symptoms improved during the early postoperative period.…”

Recurrent Thymoma-Associated Paraneoplastic Encephalitis Resulting From Multiple Antibodies: A Case Report

“…Prior reports of multiple antibodies in thymoma-associated encephalitis are rare and usually in the context of fulminant symptoms. 14,15 We further emphasize the importance of testing for antibodies in both the CSF and serum in patients with suspected autoimmune encephalitis, since antibodies detected in the CSF are typically more diagnostic. Multiple antibodies can often be associated with worse outcomes, requiring aggressive immunosuppressive therapy after treating the underlying malignancy.…”

One Patient with 3 Antibody-Confirmed Neurological Autoimmune Syndromes: A Case Report and Review of the Literature

“…In 2023, Schäfer, Christensen, and Jensen [ 22 ] described a case of a previously healthy 24 year-old man who developed first seronegative MG and then a few months later encephalitis with antibodies against AMPA and NMDA receptors. Further, there are many reports of MG concurrent with other forms of encephalitis, including anti-AMPA receptor encephalitis [ 23 ] and paraneoplastic encephalitis [ 24 – 26 ]. Notably, one case described a patient with MG and leucine-rich glioma-inactivated 1 (LGI1) protein antibody-associated encephalitis, a condition known for psychiatric symptoms similar to NMDA encephalitis, along with its hallmark faciobrachial seizures [ 27 ].…”