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NEUROLOGY 2006;67:146-149
© 2006 American Academy of Neurology
Brief Communications

Early pathologic findings and long-term improvement in anti-Ma2–associated encephalitis

D. T. Blumenthal, MD, K. L. Salzman, MD, K. B. Digre, MD, R. L. Jensen, MD, PhD, W. A. Dunson, MD and J. Dalmau, MD, PhD

From the Departments of Neurology (D.T.B., K.B.D.), Neurosurgery (D.T.B., R.L.J.), Radiology (K.S.), and Oncology Huntsman Cancer Institute (D.T.B., W.D.), University of Utah, Salt Lake City; Department of Neurology (J.D.), University of Pennsylvania. Dr. Blumenthal is currently with the Neuro-oncology Service (Neurology, Neurosurgery, and Oncology), Tel-Aviv Sourasky Medical Center, Tel Aviv University, Tel Aviv, Israel.

Address correspondence and reprint requests to Dr. Josep Dalmau, Department of Neurology, 3 W. Gates, (Section Neuro-oncology), University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104; e-mail: josep.dalmau{at}uphs.upenn.edu

A 67-year-old man sequentially developed anti-Ma2–associated paraneoplastic encephalitis (PNE) and contralateral herpes simplex encephalitis (HSE). Brain biopsy 1 month before HSE revealed extensive infiltrates of T cells, B cells, and plasma cells. Most T cells expressed the cytotoxic granule–associated protein TIA-1 and the membranolytic protein granzyme-B. Although recovery was thought to be unlikely, treatment of the PNE with corticosteroids and resection of the associated lung cancer resulted in dramatic improvement for 21 months.

Supported in part by RO1CA89054 (J.D.).

Disclosure: The authors report no conflicts of interest.

Received November 29, 2005. Accepted in final form March 13, 2006.




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