This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Convulsions, fever, and memory loss after chemotherapy are usually due to opportunistic infection, and often attributed to infection even if CSF viral PCR examination is negative. We describe a case of limbic encephalitis in a patient with relapsed Hodgkin lymphoma, in whom antibodies to the NMDA receptor were identified in serum and CSF, and whose anterograde memory improved with aggressive immunotherapy. Paraneoplastic limbic encephalitis in Hodgkin lymphoma has been reported before,1,2 but no target antigen identified. The case adds to the clinical associations of NMDA receptor antibodies.
Case report.
A 49-year-old man developed an amnesic syndrome temporally related to a second relapse of nodular sclerosing Hodgkin lymphoma. Eight years previously he had developed a large cervical lymph node and was successfully treated with mantle radiotherapy. He received chemotherapy to treat an abdominal relapse 2 years later, and maintained remission for 5 years. Last year he relapsed with a large abdominal para-aortic mass, and 3 weeks after his first cycle of treatment, with gemcitabine and cisplatin, he developed confusion and disorientation over 2 days, culminating in a generalized seizure while driving. Initial confusion and memory loss was assumed to be postictal, but his anterograde memory deficit persisted and worsened: at worst he could encode 4 of 7 parts of an address but could not recall or recognize any components at 5 minutes. He had no evidence of a movement disorder. There was no neutropenia. Erythrocyte …
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
Letters: Rapid online correspondence
REQUIREMENTS
You must ensure that your Disclosures have been updated within the previous six months. Please go to our Submission Site to add or update your Disclosure information.
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
You May Also be Interested in
Hastening the Diagnosis of Amyotrophic Lateral Sclerosis
Dr. Brian Callaghan and Dr. Kellen Quigg