Abstract

SILVA, Cátia Filipa Neto da; COSTA, Filipe Daniel Cunha  and  CUNHA, Mário Rui Portilha Antunes da. A clinical case of Paraneoplastic Encephalitis. Rev Port Med Geral Fam [online]. 2020, vol.36, n.2, pp.194-199. ISSN 2182-5173.  https://doi.org/10.32385/rpmgf.v36i2.12492.

Introduction: Encephalitis is an inflammatory condition with multiple etiologies. In most cases, the viral agents are mainly responsible, but rarely the etiology can be autoimmune/paraneoplastic. Paraneoplastic encephalitis incidence is unknown. The neoplasms most often associated with this syndrome are pulmonary carcinoma, tumor testicular, breast neoplasm, thymoma, and Hodgkin's lymphoma. It is thought that the etiopathogenic mechanism relates to the production of autoantibodies against the neuronal surface and/or synaptic proteins. Depending on the location of the nervous system affected, the symptoms vary. Limbic encephalitis is characterized by acute onset of changes in behavior, mood, short-term memory and cognitive dysfunction. Early detection and treatment improve the prognosis, the recovery time and reduce the risk of relapse. The absence of treatment may evolve into a debilitating neurological condition, culminating in coma and death. Case description: A 50-year-old woman was evaluated at the Unidade de Saúde Familiar (USF) in 2017, due to sudden amnesic and behavioral changes. In the evaluation, she presented apathy, anhedonia and a lack of speech, occasionally sketching an inappropriate laugh. She was disoriented in space, time and in relation to herself, evolving into a picture of aggressiveness and non-recognition of her relatives. The etiological investigation concluded that the situation was compatible with autoimmune/paraneoplastic encephalitis, and the patient was admitted to neurology. The investigational study showed a mass in the anterior mediastinum compatible with thymoma. In 2018, the patient underwent excision of the neoplasia, with the recovery of the neurological condition. Comment: The low prevalence of this condition and his differential diagnosis with psychiatric illness make it difficult to diagnose this syndrome. The family doctor, who knows his patients over time, is in a privileged position for the detection of alarm signs which require differentiated investigation and treatment.

Keywords : Encephalitis; Paraneoplastic syndromes; Memory; short-term; Thymoma.

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