Paraneoplastic Brainstem Encephalitis Associated with Anti-Hu Antibody

Abstract

Background: Background: Paraneoplastic brainstem encephalitis (PBE) is a rare syndrome and has been described in patients with lung and breast cancer. Several anti-neuronal nuclear antibodies are associated with PBE. Case Report: We experienced a case of a 79-year-old man who suddenly developed memory loss, diplopia and cerebellar ataxia. Brain magnetic resonance imaging (MRI) revealed high signal intensity in midbrain, pons and middle cerebellar peduncle on T2-weighted and fluid attenuation inversion recovery (FLAIR) images. Chest computed tomography (CT) revealed a lung mass ; and serum tests were positive for anti-Hu antibody. The patient was unresponsive to all treatments including immunotherapy. Conclusion: We reported a patient with acute-onset of PBE with anti-Hu antibody. Anti-Hu antibody associated brainstem encephalitis is usually non-responsive to immunotherapy. Earlier diagnosis and treatment are a challenge for improving the prognosis of paraneoplastic brainstem encephalitis.

Keywords

• Paraneoplastic brainstem encephalitis
• Lung cancer
• Anti-Hu antibody