Paraneoplastic limbic encephalitis presenting as acute viral encephalitis.
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.


METHODS
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.
Kararizou
E
E
Markou
I
I
Zalonis
I
I
Gkiatas
K
K
Triantafyllou
N
N
Kararizos
G
G
Likomanos
D
D
Zambelis
T
T
Vassilopoulos
D
D
D000208:Acute Disease; D000212:Acyclovir / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000927:Anticonvulsants / Q000627:therapeutic use; D002292:Carcinoma, Renal Cell / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D002555:Cerebrospinal Fluid / Q000382:microbiology; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D004569:Electroencephalography; D018792:Encephalitis, Viral / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D017984:Enoxaparin / Q000627:therapeutic use; D004977:Ethambutol / Q000627:therapeutic use; D005500:Follow-Up Studies; D018259:Herpesvirus 1, Human / Q000187:drug effects; D006801:Humans; D007538:Isoniazid / Q000627:therapeutic use; D020363:Limbic Encephalitis / Q000188:drug therapy / Q000473:pathology* / Q000523:psychology; D008032:Limbic System / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008590:Meningoencephalitis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D009392:Nephrectomy; D009483:Neuropsychological Tests; D020361:Paraneoplastic Syndromes, Nervous System / Q000175:diagnosis* / Q000473:pathology; D010672:Phenytoin / Q000627:therapeutic use; D012293:Rifampin / Q000627:therapeutic use; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014640:Vancomycin / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D000927:Anticonvulsants; D017984:Enoxaparin; D010672:Phenytoin; D014640:Vancomycin; D004977:Ethambutol; D007538:Isoniazid; D012293:Rifampin; D000212:Acyclovir; D008775:Methylprednisolone