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Nwabuobi et al. Thymoma associated panencephalitis

Improvement Total remission of symptoms 1 week after thymomectomy Some improvement of speech and cognitive function, but died 2 months later from mets Had thymomectomy several years prior to 3 separate presentations with ELE, 1 of which did not require treatment; the other 2 responded fairly well to steroids Improved initially with no treatment, but with recurrence, partial improvement of mental status 2 months after chemo Withi

Treatment Thymomectomy Steroids, IVIG, 1 cycle of chemotherapy Thymomectomy, steroids Thymomectomy, chemotherapy Thymomectomy, radiation therapy, steroids, IVIG, PLEX Thymomectomy Thymomectomy, steroids, PLEX

Cell surface vs. onconeuronal Ab - Cell surface Cell surface Cell surface Onconeuronal Cell surface/ onconeuronal Cell surface/ onconeuronal

Antibodies (-) AchR, Hu, Ri, Yo “Rest of paraneoplastic profile, including CRMP-5” Hu, Ri, Yo, CRMP5, Ma-2, Tr, amphiphysin, VGKC-complex AchR, Hu, Yo VGKC-complex AchR Hu, Ri, Yo, PCA- 2, amphiphysin, VGKC-complex, VGCC, neuronal AchR GAD: glutamic acid decarboxylase; VGKC: voltage gated potassium channel; AchR: acetylcholine receptor; CRMP-5: collapsing response mediator protein 5; VGCC: voltage gated calcium channel; NMDAR: N-m

Antibodies (+) - AchR (binding, modulating), striational Ab, VGKC-complex AchR GABA-A, Caspr2 GAD, neuropil of hippocampus Hu, VGKC- complex AchR (binding, modulating), striational Ab, CRMP5

Neurological symptoms Seizures, aphasia MG; 4yrs later, seizure, confusion, aphasia Seizure; later, incontinence, confusion, decreased verbal response, apallial syndrome, RLE weakness; later, decreased consciousness and apallial syndrome Memory impairment, apathy Seizure, confusion, agitation; later, spasms and rigidity Vertigo, tinnitus, vomiting; later, leg weakness and numbness, tingling of toes and fingers, R visual

Gender F F F F M F M immunoglobulin; ELE: extralimbic encephalitis; MG: myasthenia gravis

Age 55 43 33 59 38 34 55

Year 2009 2009 2007 2006 2005 2002 2000

Paper Rizzardi et al. [19] Hammoud et al. [20] Okita et al. [21] Ohshita et al. [22] Ances et al. [23] Vernino et al. [24] Rickman et al. [25]

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