PARANEOPLASTIC LIMBIC ENCEPHALITIS IN 2 TEENAGE GIRLS

Paraneoplastic neurological disorders represent remote effects of canc er without invasion of tumor cells into the nervous system. Limbic enc ephalitis is a distinct entity mostly associated with small-cell carci noma of the lung. We present the cases of two teenage girls who were a dmitted with clinical symptoms typical for limbic encephalitis. In the course of the disease, they exhibited characteristic evolutionary cha nges of brain MRI abnormalities. Onset of neurological symptoms and ty pe of underlying neoplasia were different in both patients. In one gir l the initial workup led to the diagnosis of nodular sclerosing Hodgki n disease which so far had not caused any symptoms besides the describ ed neurological abnormalities. A diagnostic brain biopsy showed inflam matory changes and excluded invasion of malignant cells into the centr al nervous system. The other patient had been diagnosed with a small c ell carcinoma of the ovary several months before neurological and brai n MRI abnormalities were observed. This is the first report in which c linical picture, evolution of MRI abnormalities, and - in one case - c haracteristic neuropathological changes are suggestive of paraneoplast ic limbic encephalitis in two adolescent girls.