脑结核合并副肿瘤脑炎1例

Bhavika Kakadia Do
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引用次数: 0

摘要

电压门控钾通道(VGKC)抗体见于许多疾病,包括边缘脑炎。它通常累及内侧颞叶,在极少数情况下累及双侧小脑叶。患者可以表现为癫痫发作,经常出现精神状态警觉和幻觉。脑结核(TB)倾向于后颅窝,患者通常表现为头痛、癫痫发作和意识不清。然而,VGKC脑炎与播散性结核之间没有特别的联系。两者的存在可能限制副肿瘤脑炎的治疗选择。我们提出一个病例的年轻女性播散性结核谁也被发现有不典型的放射表现结核脑炎/脑膜炎和VGKC抗体有关副肿瘤脑炎。患者接受类固醇和免疫球蛋白治疗以及播散性结核病的治疗。总的来说,在存在弥散性结核的情况下,副肿瘤脑炎的治疗是有限的,应采用多学科方法,并应监测临床改善情况。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A rare case of cerebral tuberculosis and paraneoplastic encephalitis
Voltage gated potassium channel (VGKC) antibodies are seen in many conditions including limbic encephalitis. It typically involves medial temporal lobe, and in rare instances, bilateral cerebellar lobes. Patients can present with seizures and often with alerted mental status and hallucinations. Cerebral tuberculosis (TB)tends to prefer posterior fossa and patients typically present with headache, seizures, and confusion. However, there is no particular association between VGKC encephalitis and disseminated tuberculosis. Presence of both may limit treatment options for paraneoplastic encephalitis. We present a case of a young female with disseminated TB who was also found to have atypical radiographic presentation of TB encephalitis/meningitis and VGKC antibody concerning for paraneoplastic encephalitis. The patient received treatment with steroids and immunoglobulin therapy along with treatment for disseminated tuberculosis. Overall, treatment of paraneoplastic encephalitis is limited in the presence of disseminated TB and a multidisciplinary approach should be used and clinical improvement should be monitored.
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