Hypersomnia as presenting symptom of anti-Ma2-associated encephalitis: case study.
We describe a patient who presented with excessive daytime sleepiness (EDS) and was eventually diagnosed with anti-Ma2 encephalitis. Neurological examination disclosed somnolence, left palpebral ptosis, and vertical gaze paresis. A brain MRI showed high signal intensity in the hypothalamus and each hippocampus. Ma2 antibodies were found in the patient's serum, and fiberbronchoscopy disclosed a lung carcinoma. After three months of steroid treatment, the results of the patient's neurological exam became normal. We conclude that anti-Ma2 encephalitis may present with mostly isolated EDS and that it may respond to steroids despite old age and the presence of an untreated lung cancer.
Rojas-Marcos
Iñigo
I
Department of Neurology, Hospital Juan Ramón Jiménez, Ronda Norte s/n, 21005 Huelva, Spain. irojasm@meditex.es
Graus
Francesc
F
Sanz
Gema
G
Robledo
Arturo
A
Diaz-Espejo
Carlos
C
D000368:Aged; D000951:Antigens, Neoplasm / Q000276:immunology / Q000378:metabolism*; D006970:Disorders of Excessive Somnolence / Q000175:diagnosis*; D004660:Encephalitis / Q000175:diagnosis* / Q000276:immunology / Q000628:therapy; D006801:Humans; D008297:Male; D009419:Nerve Tissue Proteins / Q000276:immunology / Q000378:metabolism*
D000951:Antigens, Neoplasm; C119249:Ma2 antigen; D009419:Nerve Tissue Proteins