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Neuropsychological functioning in a patient with paraneoplastic limbic encephalitis

Published online by Cambridge University Press:  26 February 2009

Roy C. Martin
Affiliation:
Department of Neurology, School of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294
Marc W. Haut
Affiliation:
Department of Behavioral Medicine & Psychiatry, School of Medicine, University of West Virginia, Morgantown, WV 26505 Department of Neurology, School of Medicine, University of West Virginia, Morgantown, WV 26505
Kevin Goeta-Kreisler
Affiliation:
Department of Neurology, School of Medicine, University of West Virginia, Morgantown, WV 26505
Deborah Blumenthal
Affiliation:
Department of Neurology, School of Medicine, University of West Virginia, Morgantown, WV 26505

Abstract

A 54-year-old woman with clinically diagnosed paraneoplastic limbic encephalitis secondary to adenocarcinoma of the lung is described. Neuropsychological evaluation revealed intact visual perception, visual construction, language, speeded processing, and verbal abstract reasoning in the presence of a severe anterograde amnesia for both verbal and visual information. A profound consolidation problem is discussed in view of other diseases of the mesial temporal lobes resulting in impaired consolidation of new material. (JINS, 1996, 2, 460–466.)

Type
Case Study
Copyright
Copyright © The International Neuropsychological Society 1996

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References

REFERENCES

Ahern, G.L., O'Conner, M., Dalmau, J., Coleman, A., Posner, J.B., Schomer, D.L., Herzog, A.G., Kolb, D.A., & Mesulam, M.M. (1994). Paraneoplastic temporal lobe epilepsy with testicular neoplasm and atypical amnesia. Neurology, 44, 12701274.CrossRefGoogle ScholarPubMed
Bakheit, A.M.O., Kennedy, P.G.E., & Behan, P.O. (1990). Paraneoplastic limbic encephalitis: Clinico-pathological correlations. Journal of Neurology, Neurosurgery, and Psychiatry, 53, 10841088.CrossRefGoogle ScholarPubMed
Bauer, R.M., Tobias, B., & Valenstein, E. (1993). Amnesic disorders. In Heilman, K. & Valenstein, E. (Eds.), Clinical neuropsychology (3rd ed.) (pp. 523602). New York: Oxford University Press.Google Scholar
Bennett, T.L. (1992). Cognitive effects of epilepsy and anticonvulsant medications. In Bennett, T.L. (Ed.), The neuropsychology of epilepsy (pp. 7395). New York: Plenum Press.CrossRefGoogle Scholar
Benton, A. & Hamsher, K. des. (1978). Multilingual Aphasia Examination. Iowa City: University of Iowa.Google Scholar
Benton, A., Hamsher, K. des., Varney, N., & Spreen, O. (1983). Contributions to neuropsychological assessment. New York: Oxford University Press.Google Scholar
Brierley, J.B., Corsellis, J.A.N., Hierons, R., & Nevin, S. (1960). Subacute encephalitis of later adult life mainly affecting the limbic areas. Brain, 83, 357368.CrossRefGoogle Scholar
Butters, N. & Stuss, D.T. (1989). Diencephalic amnesia. In Boiler, F. & Grafman, J. (Eds.), Handbook of neuropsychology (pp. 107148). New York: Elsevier Science.Google Scholar
Camara, E.G., & Chelune, G.J. (1987). Paraneoplastic limbic encephalopathy. Brain, Behavior and Immunology, 1, 349355.CrossRefGoogle ScholarPubMed
Corsellis, J.A.N., Goldberg, G.J., & Norton, A.R. (1968). Limbic encephalitis and its association with carcinoma. Brain, 91, 481496.CrossRefGoogle ScholarPubMed
Dalmau, J., Graus, F., Roscnblum, M.D., & Posner, J.B. (1992). Anti-hu-associatcd paraneoplastic encephalomyelitis/sensory neuropathy: A clinical study of 71 patients. Medicine, 71, 5972.CrossRefGoogle ScholarPubMed
Damasio, A.R., Tranel, D., & Damasio, H. (1989). Amnesia caused by herpes simplex encephalitis, infarctions in basal forebrain, Alzheimer's disease and anoxia/ischemia. In Boller, F. & Grafman, J. (Eds.), Handbook of neuropsychology (pp. 149166). New York: Elsevier Science.Google Scholar
Delis, D.C., Kramer, J.H., Kaplan, E., & Ober, B.A. (1987). The California Verbal Learning Test-Research edition. New York: Psychological Corp.Google Scholar
Denman, S.B. (1984). Denman neuropsychology memory scale. Charleston, SC: Author.Google Scholar
Folstein, M.F., Folstein, S.E., & McHugh, P.R. (1975). “Mini-mental state”: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198.CrossRefGoogle ScholarPubMed
Glaser, G.H., & Pincus, J.H. (1969). Limbic encephalitis. The Journal of Nervous and Mental Disease, 149, 5967.CrossRefGoogle ScholarPubMed
Goodglass, H. & Kaplan, E. (1983). The assessment of aphasia and related disorders (2nd ed.). Philadelphia: Lea & Febiger.Google Scholar
Gordon, B., Selnes, O., Hart, J., Hanley, D., & Whitley, R. (1990). Long-term cognitive sequelae of acyclovir-treated herpes simplex encephalitis. Archives of Neurology, 47, 646647.CrossRefGoogle ScholarPubMed
Graff-Radford, N.R., Tranel, D., Van Hoesen, G.W., & Brandt, J.P. (1990). Diencephalic amnesia. Brain, 113, 125.CrossRefGoogle ScholarPubMed
Greenwood, R., Bhalla, A., Gordon, A., & Roberts, J. (1983). Behaviour disturbances during recovery from herpes simplex encephalitis. Journal of Neurology, Neurosurgery, and Psychiatry, 46, 809817.CrossRefGoogle ScholarPubMed
Hart, R.P., Kwentus, J.A., Taylor, J.R., & Harkins, S.W. (1987a). Rate of forgetting in dementia and depression. Journal of Consulting and Clinical Psychology, 55, 101105.CrossRefGoogle ScholarPubMed
Hart, R.P., Kwentus, J.A., Wade, J.B., & Hamer, R.M. (1987b). Digit symbol performance in mild dementia and depression. Journal of Consulting and Clinical Psychology, 55, 236238.CrossRefGoogle ScholarPubMed
Haut, M.W., Weber, A.M., Wilhelm, K.L., Keefover, R.W., & Rankin, E.D. (1994). The visual reproduction subtest as a measure of visual perceptual/constructional functioning in dementia of the Alzheimer's type. The Clinical Neuropsychologist, 8, 187192.CrossRefGoogle Scholar
Iverson, G.L., Franzen, M.D., & McCracken, L.M. (1991). Evaluation of an objective assessment technique for the detection of malingered memory deficits. Law and Human Behavior, 15, 667676.CrossRefGoogle Scholar
Kaniecki, R. & Morris, J.C. (1993). Reversible paraneoplastic limbic encephalitis. Neurology, 43, 24182419.CrossRefGoogle ScholarPubMed
Kaplan, E., Goodglass, H., & Weintraub, S. (1983). The Boston Naming Test. Philadelphia: Lea & Febiger.Google Scholar
Kapur, N., Barker, S.Burrows, E.H., Ellison, D., Brice, J., Illis, L.S., Colburn, C., Wilson, B., & Loates, M. (1994). Herpes simplex encephalitis: Long-term magnetic resonance imaging and neuropsychological profile. Journal of Neurology, Neurosurgery, and Psychiatry, 57, 13341342.CrossRefGoogle ScholarPubMed
Morris, J.C., Heyman, A., Mohs, R.C., Hughes, J.P., van Belle, G., Fillenbaum, G., Mellits, E.D., Clark, C., and the CERAD investigators. (1989). The consortium to establish a registry for Alzheimer's disease (CERAD). Part I. Clinical and neuropsychological assessment of Alzheimer's disease. Neurology, 39, 11591165.Google ScholarPubMed
Newman, N.J., Bell, I.R., & McKee, A.C. (1990). Paraneoplastic limbic encephalitis: Neuropsychiatric presentation. Biological Psychiatry, 27, 529542.CrossRefGoogle ScholarPubMed
Palma, G. (1985). Paraneoplastic syndromes of the nervous system. Western Journal of Medicine, 142, 787796.Google ScholarPubMed
Parkin, A.J., & Lang, N.R.C. (1993). Neuropsychology of the amnesic syndrome. Hillsdale, NJ: Lawrence Erlbaum Associates.Google Scholar
Paul, D.S., Franzen, M.D., Cohen, S.H., & Fremouw, W. (1992). An investigation into the reliability and validity of two tests used in the detection of dissimulation. International Journal of Clinical Neuropsychology, 14, 19.Google Scholar
Posner, J.B. (1995). Paraneoplastic syndromes involving the nervous system. In Aminoff, M. J. (Ed.), Neurology and general medicine (2nd ed.) (pp. 401420). New York: Churchill Livingstone.Google Scholar
Rao, S.M., Mittenberg, W., Bernardin, L., Haughton, V., & Leo, G.J. (1989). Neuropsychological test findings in subjects with leukoaraiosis. Archives of Neurology, 46, 4044.CrossRefGoogle ScholarPubMed
Richardson, E.P. (1985). Case records of the Massachusetts General Hospital (Case 30–1985). New England Journal of Medicine, 313, 249257.Google Scholar
Satz, P. (1993). Brain reserve capacity on symptom onset after brain injury: A formulation and review of evidence for threshold theory. Neuropsychology, 7, 273295.CrossRefGoogle Scholar
Warrington, E.K. (1984). Recognition Memory Test. Berkshire, UK: NFER-Nelson.Google Scholar
Wechsler, D. (1981). Wechsler Adult Intelligence Scale-Revised. New York: Psychological Corporation.Google Scholar
Wechsler, D. (1987). Wechsler Memory Scale-Revised. New York: Psychological Corporation.Google Scholar
Winocur, G., Oxbury, S., Roberts, R., Agnctti, V., & Davis, C. (1984). Amnesia in a patient with bilateral lesions to the thalamus. Neuropsychologia, 22, 123143.CrossRefGoogle Scholar
Wolfe, N., Linn, R., Babikian, V.L., Knoefel, J.E., & Albert, M.L. (1990). Frontal systems impairment following multiple lacunar infarcts. Archives of Neurology, 47, 129132.CrossRefGoogle ScholarPubMed
Yanagihara, T. (1991). Memory disorders in encephalitides, ce-cephalopathies, and demyclinating diseases. In Yanagihara, T. & Peterson, R. C. (Eds.), Memory disorders: Research and clinical practice (pp. 397411). New York: Marcel Dekker.Google Scholar