PARANEOPLASTIC TEMPORAL-LOBE EPILEPSY WITH TESTICULAR NEOPLASM AND ATYPICAL AMNESIA

We report a patient who, at age 38, presented with temporal lobe seizu res and an atypical memory disorder 3 years before the discovery of a testicular tumor. Detailed neuropsychological testing revealed a relat ively isolated amnestic syndrome. The amnesia was atypical as the pati ent could retain information for hour-long periods, only to lose it la ter. Serologic studies revealed the presence of a circulating autoanti body that demonstrated an unusual affinity for the nucleolus of cerebr al cortical neurons. Western blot analysis of cortical neurons reveale d that this antibody reacted with proteins different from other previo usly identified paraneoplastic neurologic antigens (Hu, Yo, Ri). We be lieve this to be a case of paraneoplastic limbic encephalitis secondar y to the testicular tumor. This patient presents unique characteristic s with respect to the mode of presentation, features of the amnesia, a nd the presence of a circulating antibody with an unusual reactivity p attern.