ABSTRACT
We report a young patient who developed a stiff man syndrome (SMS) long after remission of Hodgkin lymphoma. This patient is remarkable because he has had several other potentially autoimmune or paraneoplastic neurological syndromes including limbic encephalitis and demyelinating polyneuropathy which also occurred years after remission from Hodgkin disease.
Subject(s)
Hodgkin Disease/complications , Paraneoplastic Syndromes, Nervous System/etiology , Stiff-Person Syndrome/etiology , Adult , Hodgkin Disease/therapy , Humans , Male , Remission InductionSubject(s)
Anti-Infective Agents/adverse effects , Corpus Callosum/pathology , Metronidazole/adverse effects , Vision Disorders/etiology , Adult , Colitis, Ulcerative/drug therapy , Diagnosis, Differential , Evoked Potentials, Visual , Humans , Magnetic Resonance Imaging , Male , Multiple Sclerosis/pathologyABSTRACT
Four patients with refractory epilepsy presented with psychotic symptoms following treatment with vagus nerve stimulation (VNS) to control seizures. Besides its anti-epileptic effect VNS has been shown to have an effect on various cognitive and behavioural functions. VNS is known to increase alertness and reduce sedation, which is independent from seizure control. VNS has also been shown to positively affect cognition and to exert strong antidepressant effects. Co-morbidity in epilepsy often comprises psychiatric illnesses. Increased psychiatric symptoms have mainly been described in association with successful outcome following epilepsy surgery as a result of 'forced normalisation'. Different hypotheses on the underlying aetiology of VNS-induced psychotic symptoms other than the previously described 'forced normalisation' are discussed.
