Glazed (vision) and confused.

Abstract

A 60-year-old man presented with vitritis and optic neuropathy in the setting of headaches and behavioral changes. MRI brain revealed bilateral temporal lobe inflammation consistent with limbic encephalitis. He was subsequently diagnosed with small cell lung cancer with a paraneoplastic syndrome characterized by CRMP5 IgG as a cause of his symptoms. His visual symptoms improved markedly after anti-inflammatory therapy and his cognitive symptoms were mildly better following systemic chemotherapy. The clinical presentation, pathophysiology, and therapy of CRMP5 associated paraneoplastic syndromes are discussed.

• Authors: Heather E Moss, Grant T Liu, Josep Dalmau
• Journal: Survey of ophthalmology (Surv Ophthalmol) 2010 Mar-Apr Vol. 55 Issue 2 Pg. 169-73 ISSN: 1879-3304 [Electronic] United States
• PMID: 19804892 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright 2010 Elsevier Inc. All rights reserved.

Chemical References

• Antineoplastic Agents
• Glucocorticoids
• Immunoglobulin G
• Microtubule-Associated Proteins
• Nerve Tissue Proteins
• DPYSL5 protein, human
• Hydrolases

Topics

• Antineoplastic Agents (therapeutic use)
• Cognition Disorders (diagnosis)
• Electroencephalography
• Eye Diseases (diagnosis)
• Glucocorticoids (therapeutic use)
• Humans
• Hydrolases
• Immunoglobulin G (blood)
• Lung Neoplasms (diagnosis, drug therapy, immunology)
• Magnetic Resonance Imaging
• Male
• Microtubule-Associated Proteins
• Middle Aged
• Nerve Tissue Proteins (immunology)
• Optic Nerve Diseases (diagnosis)
• Paraneoplastic Syndromes (diagnosis, drug therapy, immunology)
• Small Cell Lung Carcinoma (diagnosis, drug therapy, immunology)
• Tomography, X-Ray Computed
• Vitreous Body (pathology)