TY - JOUR
T1 - Anti-Ma2-associated encephalitis with normal FDG-PET
T2 - A case of pseudo-Whipple's disease
AU - Castle, James
AU - Sakonju, Ai
AU - Dalmau, Josep
AU - Newman-Toker, David E.
PY - 2006/10
Y1 - 2006/10
N2 - Background. A 39-year-old man presented with a history of several months of progressive personality changes, social withdrawal, bradykinesia, mutism, dysphagia, worsening gait, and difficulty with daily living activities. Examination revealed an atypical parkinsonian appearance with incomplete supranuclear ophthalmoplegia and an unusual oculomotor disorder characterized by both low-amplitude, intermittent opsoclonus, and slow, nystagmoid intrusions. Investigations. Routine laboratory testing, autoimmune and infectious serologies, brain MRI, lumbar puncture, electroencephalogram, whole-body CT scan, paraneoplastic serologies, small bowel biopsy, 18 F-fluorodeoxyglucose positron emission tomography CT scan, brain biopsy, and testicular ultrasound. Diagnosis. Anti-Ma2 paraneoplastic encephalit is in association with metastatic testicular cancer; initially misdiagnosed as CNS Whipple's disease. Management. Corticosteroids, intravenous immunoglobulins, orchiectomy, muscle relaxants, mycophenolate mofetil, plasmapheresis, and bleomycin, etoposide and platinum chemotherapy.
AB - Background. A 39-year-old man presented with a history of several months of progressive personality changes, social withdrawal, bradykinesia, mutism, dysphagia, worsening gait, and difficulty with daily living activities. Examination revealed an atypical parkinsonian appearance with incomplete supranuclear ophthalmoplegia and an unusual oculomotor disorder characterized by both low-amplitude, intermittent opsoclonus, and slow, nystagmoid intrusions. Investigations. Routine laboratory testing, autoimmune and infectious serologies, brain MRI, lumbar puncture, electroencephalogram, whole-body CT scan, paraneoplastic serologies, small bowel biopsy, 18 F-fluorodeoxyglucose positron emission tomography CT scan, brain biopsy, and testicular ultrasound. Diagnosis. Anti-Ma2 paraneoplastic encephalit is in association with metastatic testicular cancer; initially misdiagnosed as CNS Whipple's disease. Management. Corticosteroids, intravenous immunoglobulins, orchiectomy, muscle relaxants, mycophenolate mofetil, plasmapheresis, and bleomycin, etoposide and platinum chemotherapy.
UR - http://www.scopus.com/inward/record.url?scp=33748987621&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33748987621&partnerID=8YFLogxK
U2 - 10.1038/ncpneuro0287
DO - 10.1038/ncpneuro0287
M3 - Article
C2 - 16990830
AN - SCOPUS:33748987621
SN - 1745-834X
VL - 2
SP - 566
EP - 572
JO - Nature Clinical Practice Neurology
JF - Nature Clinical Practice Neurology
IS - 10
ER -