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J Neurooncol ; 75(2): 229-32, 2005 Nov.
Article in English | MEDLINE | ID: mdl-16283448

ABSTRACT

OBJECTIVE: To describe a case of limbic encephalitis which initially presented as viral limbic encephalitis and during the clinical evaluation a renal carcinoma was diagnosed. CASE REPORT: Patient with history of peripheral paresis of right facial nerve, 1 month after symptoms appearance and treatment, developed fever, vomiting, grand mal seizure, decreased level of consciousness, confusion, hallucinations and agitation. The patient initially presented a clinical picture of viral LE. which confirmed by CSF. MRI brain showed areas with pathological intensity signal in the region of limbic system unilateral. During the clinical evaluation a renal carcinoma was discovered and a nephrectomy has been performed. CONCLUSIONS: Although PLE typically presents as a chronic or subacute disease, it may be fulminant and clinically indistinguishable from an acute HSVE. This association pose the problem of a possible relation between this two syndromes and the correct diagnosis is very important, because there are effective treatments.


Subject(s)
Carcinoma, Renal Cell/complications , Encephalitis, Viral/diagnosis , Limbic Encephalitis/pathology , Limbic System/pathology , Paraneoplastic Syndromes, Nervous System/diagnosis , Acute Disease , Acyclovir/therapeutic use , Anti-Bacterial Agents/therapeutic use , Anticonvulsants/therapeutic use , Carcinoma, Renal Cell/diagnostic imaging , Carcinoma, Renal Cell/pathology , Carcinoma, Renal Cell/surgery , Cerebrospinal Fluid/microbiology , Diagnosis, Differential , Drug Therapy, Combination , Electroencephalography , Encephalitis, Viral/cerebrospinal fluid , Encephalitis, Viral/drug therapy , Encephalitis, Viral/etiology , Enoxaparin/therapeutic use , Ethambutol/therapeutic use , Follow-Up Studies , Herpesvirus 1, Human/drug effects , Humans , Isoniazid/therapeutic use , Limbic Encephalitis/drug therapy , Limbic Encephalitis/psychology , Magnetic Resonance Imaging , Male , Meningoencephalitis/diagnosis , Meningoencephalitis/drug therapy , Meningoencephalitis/etiology , Methylprednisolone/therapeutic use , Middle Aged , Nephrectomy , Neuropsychological Tests , Paraneoplastic Syndromes, Nervous System/pathology , Phenytoin/therapeutic use , Rifampin/therapeutic use , Time Factors , Tomography, X-Ray Computed , Treatment Outcome , Vancomycin/therapeutic use
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