CASE PRESENTATION: This case report describes the new onset of
seizures in a 64-year-old male patient receiving
chemotherapy for a diagnosed stage IV
non-small cell lung carcinoma. After three cycles of
therapy, he was re-evaluated with a chest computed tomography which showed a 50% reduction in the
tumor mass and in the size of the hilar and mediastinal
lymphadenopathy. Twenty days after the fourth cycle of
chemotherapy, the patient was admitted to a neurological clinic because of the onset of self-limiting
complex partial seizures, with motionless stare and facial twitching, but with no signs of secondary generalization. The patient had also recently developed neurological symptoms of short-term memory loss and temporary
confusion, and behavioral changes. Laboratory evaluation included brain magnetic resonance imaging, magnetic resonance spectroscopy of the brain, serum examination for 'anti-Hu'
antibodies and stereotactic brain biopsy. Based on the clinical picture, the patient's history of
lung cancer, the brain magnetic resonance imaging findings and the results of the brain biopsy, we concluded that our patient had a 'definite' diagnosis of
paraneoplastic limbic encephalitis and he was subsequently treated with a combination of
chemotherapy and oral
steroids, resulting in stabilization of his neurological status. Despite the neurological stabilization, a chest computed tomography which was performed after the 6th cycle showed relapse of the disease in the chest.
CONCLUSION: