PARANEOPLASTIC LIMBIC ENCEPHALITIS IN HODGKINS-DISEASE

Background: Oat cell carcinoma of the lung is the most common cause of paraneoplastic limbic encephalitis. Association with other malignanci es, in particular Hodgkin's disease, is very rare. Case Report: This 2 3-year-old male presented with a six month history of progressive alte ration in mental status, which consisted of insomnia, short-term memor y loss, depression and cognitive impairment. Gadolinium MRI of the hea d showed intense bilateral contrast enhancement affecting the medial a spects of the temporal lobes in the region of the amygdala and hippoca mpus. The brain biopsy showed minimal neuronal loss with intense periv ascular lymphocytic cuffing and microglial nodules. Polymerase chain r eaction for herpes simplex and cytomegalovirus were negative. With pre dnisone treatment, the patient's neurologic status stabilized but did not improve. Four months later, he presented with left axillary lympha denopathy. Lymph node biopsy was diagnostic of Hodgkin's disease. Duri ng the chemotherapy, his lymphadenopathy subsided and his neurologic a nd mental status improved. When seen last after completion of his chem otherapy, one year after presentation, he had resumed normal social ac tivities and was enrolled in a university language course. Conclusion: This is the first reported case in the English literature of a biopsy proven paraneoplastic limbic encephalitis associated with Hodgkin's d isease. Hodgkin's disease should be thought of as a possible cause of paraneoplastic limbic encephalitis in the appropriate clinical setting .