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Neuro Oncol 2003 5(3):214-216; DOI:10.1215/S1152851702000467
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Duke University Press

Clinical Neuro-Oncology

Paraneoplastic limbic encephalitis and possible narcolepsy in a patient with testicular cancer: Case study

Joseph C. Landolfi1 and Mangala Nadkarni

New Jersey Neuroscience Institute—JFK Medical Center, Edison, NJ 08818, and Seton Hall University School of Graduate Medical Education, South Orange, NJ 07079, USA

1 Address correspondence to Joseph C. Landolfi, Assistant Professor of Neurology, New Jersey Neuroscience Institute—JFK Medical Center, 65 James Street, Edison, NJ 08818, USA (jlandolfi{at}solarishs.org).

Abstract

We describe a patient who presented with a clinical syndrome of limbic encephalitis, narcolepsy, and cataplexy. The anti-Ma2 antibody was positive. Although there was no mass on imaging, orchiectomy was performed in this patient, and testicular carcinoma was found. This is the first known case of limbic encephalitis and anti-Ma2 antibody to be associated with cataplexy and possible narcolepsy. Neurological symptoms precede the diagnosis of cancer in 50% of patients with paraneoplastic syndromes, and clinicians are therefore strongly advised to evaluate patients with neurological symptoms for this condition.




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