paraneoplastic limbic encephalitis
Introduction
Introduction to paraneoplastic limbic encephalitis Paraneoplastic syndrome (PNS) is a remote effect of systemic cancer in the central nervous system (CNS) and the muscular system. When the limbic system is mainly involved, it is clinically manifested as amnesia syndrome. basic knowledge The proportion of sickness: 0.0051% Susceptible people: no special people Mode of infection: non-infectious Complications: amnesia syndrome
Cause
Paraneoplastic limbic encephalitis
(1) Causes of the disease
The primary tumor of limbic encephalitis and brain stem inflammation is small cell lung cancer or Hodgkin's disease. Homosexual thymoma can sometimes cause this disease. The cause is still unclear, but other Anti-neuron autoantibodies are found in the paraneoplastic syndrome.
(two) pathogenesis
Marginal encephalitis or brain stem inflammation is not a focal lesion. There are pathological changes in all levels of CNS. The main pathological features are a large number of neuron loss and microglia hyperplasia, hemisphere and marginal lobe are most prominent, and the posterior root ganglia also has Inflammatory lesions, the cause may be a viral infection, but no biological evidence has been found so far.
Prevention
Paraneoplastic limbic system encephalitis prevention 1. Maintain an optimistic and happy mood. Long-term mental stress, anxiety, irritability, pessimism and other emotions will make the balance of the cerebral cortex excitatory and inhibition process imbalance, so you need to maintain a happy mood. 2, life restraint pay attention to rest, work and rest, life orderly, maintain an optimistic, positive, upward attitude towards life has a great help to prevent disease. Do the regularity of tea and rice, live daily, not overworked, open-minded, and develop good habits.
Complication
Paraneoplastic limbic system encephalitis complications Complications amnesia syndrome
The amnesia syndrome caused by paraneoplastic marginal system encephalitis is often accompanied by symptoms of damage in other parts, depending on the damage of the nervous system parts outside the affected limbic system, such as the cerebellum, medulla, pyramidal tract, and peripheral nerves. .
Symptom
Paraneoplastic limbic system of cerebral symptoms common symptoms dementia paralysis myoclonus depression cerebellar signs anxiety memory impairment illusion
The characteristic symptoms of this disease are progressive dementia and obvious memory disorders, especially near-memory memory disorders, as well as systemic seizures, myoclonus, speech disorders and cerebellar signs. In addition to visible brain nerves Paralysis, there may be a lack of central ventilation.
The clinical manifestations of amnesia syndrome caused by paraneoplastic limbic encephalitis may be static, progressive or recurrent manifestations. The clinical manifestations of patients are characterized by severe memory impairment and a significant decline in the ability to learn new things. In the distant memory, memory damage is generally mild, recording ability is not affected, and fiction may occur in some cases. Anxiety and depression usually occur in the early stage of the syndrome, and hallucinations and partial or systemic seizures may also occur. In many cases, the amnesia syndrome progresses progressively until it develops into dementia.
Paraneoplastic limbic encephalitis is most often associated with the development of small cell lung cancer, and the presence of its syndrome is generally preceded by the discovery of lung cancer.
Examine
Examination of paraneoplastic limbic encephalitis
1. A small amount of monocytes in the cerebrospinal fluid increase, and moderate levels of protein increase.
2. Serological examination Sometimes an antibody against the neuronal Ma2 protein can be found.
3. EEG: Sometimes manifested as diffuse slow waves, or double-twisted slow waves, or spikes.
4. MRI: Abnormal signal images can be seen in the structures of the middle temporal lobe, hippocampus, cingulate gyrus, island leaf and amygdala.
5. Histological examination: found in the cerebral cortex, neuronal loss, reactive gliosis, microglia hyperplasia and peripheral vascular lymphocytes in a sleeve-like aggregation infiltration, in the hippocampus, cingulate, piriform cortex, The gray matter of the inferior lobes, the insular leaves, and the amygdala is the most common lesion.
Diagnosis
Diagnosis and identification of paraneoplastic limbic encephalitis
1. Mainly based on the clinical symptoms and signs of amnesia syndrome caused by encephalitis in patients.
2. There is a primary tumor. Brain parenchyma or meningeal tumor metastasis, metabolic encephalopathy, etc. must be excluded.
