The paraneoplastic limbic encephalitis: MRI characterization of a deceiving neurological disorder.
OBJECTIVE
Establishing diagnostic MRI criteria for such a pathological entity to enable the oncologist to modify the treatment plan combating the neurological deficits from a different diagnostic prospective, hence improving the quality of life of cancer patients.


METHODS
Sixty patients from the National Cancer Institute (Cairo University) diagnosed with different types of cancer at time interval of one year were included in the study pool. Twenty patients were known to have lung cancer, 15 patients with breast cancer, 10 patients with lymphoma and 15 patients with leukemia. No age or sex predilection. All patients performed cranial MRI before and after intravenous contrast media injection, backed by the clinical assumption of encephalopathy and wide spectrum of neurological symptoms as seizures, dementia and behavioral disorders. Some of the patients with positive MRI studies performed serological test to detect onconeuronal antibodies. The study was carried out from January till December 2007.


RESULTS
Thirty three patients' revealed definite MRI signal abnormality involving the limbic system proper and further temporal lobes affection while five patients revealed mixed pattern of regional encephalitic changes including the cerebellum, frontal lobes and brain stem. The rest of the study group exhibited no signs of encephalitis.


CONCLUSIONS
Specific MRI appearance could be traced in paraneoplastic limbic encephalitis thus establishing diagnostic pattern for such entity that could help characterizing the disease with subsequent impact upon the treatment protocol resulting in regaining normal brain faculties and better life quality for such cancer patients.


BACKGROUND
Paraneoplastic - Limbic encephalitis - MRI.
Eloraby
Alaa M
AM
The Department of Radiology, National Cancer Institute, Cairo University, Egypt.