title: Brainstem and limbic encephalitis with paraneoplastic neuromyelitis optica.
abstract: The spectrum of disorders associated with anti-neuromyelitis optica (NMO) antibody is being extended to include infrequent instances associated with cancer. We describe a patient with brainstem and limbic encephalitis from NMO-immunoglobulin G in serum and cerebrospinal fluid in the context of newly diagnosed breast cancer. The neurological features markedly improved with excision of her breast cancer and immune suppressive therapy. This case further broadens the NMO spectrum disorders (NMOSD) by an association between NMOSD and cancer and raises the question of coincidental occurrence and the appropriate circumstances to search for a tumor in certain instances of NMO.
authors.affiliation: Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA; Department of Neurology, Massachusetts General Hospital, Wang Ambulatory Care Center, Suite 835, 55 Fruit Street, Boston, MA 02114, USA; Harvard Medical School, Boston, MA, USA. Electronic address: kmoussawi@partners.org.
authors.forename: Khaled
authors.initials: K
authors.lastname: Moussawi
authors.affiliation: Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA; Department of Neurology, Massachusetts General Hospital, Wang Ambulatory Care Center, Suite 835, 55 Fruit Street, Boston, MA 02114, USA; Harvard Medical School, Boston, MA, USA.
authors.forename: David J
authors.initials: DJ
authors.lastname: Lin
authors.affiliation: Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA; Department of Neurology, Massachusetts General Hospital, Wang Ambulatory Care Center, Suite 835, 55 Fruit Street, Boston, MA 02114, USA; Harvard Medical School, Boston, MA, USA.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Matiello
authors.affiliation: Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA; Department of Neurology, Massachusetts General Hospital, Wang Ambulatory Care Center, Suite 835, 55 Fruit Street, Boston, MA 02114, USA; Harvard Medical School, Boston, MA, USA.
authors.forename: Sheena
authors.initials: S
authors.lastname: Chew
authors.affiliation: Harvard Medical School, Boston, MA, USA; Dana-Farber Cancer Institute, Boston, MA, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Morganstern
authors.affiliation: Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
authors.forename: Henrikas
authors.initials: H
authors.lastname: Vaitkevicius
mesh_terms: D000328:Adult; D001323:Autoantibodies / Q000276:immunology; D001933:Brain Stem / Q000276:immunology / Q000473:pathology*; D001943:Breast Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000276:immunology; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology; D020363:Limbic Encephalitis / Q000150:complications / Q000175:diagnosis* / Q000276:immunology; D009471:Neuromyelitis Optica / Q000150:complications / Q000175:diagnosis* / Q000276:immunology
chemical_list: D001323:Autoantibodies; D007074:Immunoglobulin G
keywords: Brainstem encephalitis; Breast cancer; Limbic encephalitis; Neuromyelitis optica; Neuromyelitis optica spectrum disorders; Paraneoplastic syndrome