Isolated frontal disequilibrium as presenting form of anti‐Hu paraneoplastic encephalomyelitis
Identifieur interne : 003117 ( Istex/Corpus ); précédent : 003116; suivant : 003118Isolated frontal disequilibrium as presenting form of anti‐Hu paraneoplastic encephalomyelitis
Auteurs : Yaroslau Compta ; Francesc Valldeoriola ; Xabier Urra ; Beatriz G Mez-Ans N ; Lorena Rami ; Eduardo Tolosa ; Francesc GrausSource :
- Movement Disorders [ 0885-3185 ] ; 2007-04-15.
English descriptors
Abstract
Anti‐Hu encephalomyelitis is one of the most frequent paraneoplastic syndromes, classically presenting with diffuse neurological involvement. We report a 69‐year‐old man presenting with a three‐month isolated, progressive gait disorder with normal neurological examination, except for loss of balance and gait failure reminding frontal disequilibrium, only accompanied by a very mild rigidity of his right foot. MRI of the brain showed hyperintensities in both amygdale and left putamen. EMG study showed no abnormal continuous spontaneous fiber activity. Because of fast progression and MRI findings, anti‐Hu antibodies were tested, resulting positive. Mediastinal biopsy of two adenopathies detected by body‐PET, confirmed an oat‐cell carcinoma. The patient received oral steroids and oncological therapy. One year later, the tumor is in remission. His gait and abnormal posture of right leg are normal. Only mild residual hyperintensities persist on follow‐up MRI. A paraneoplastic syndrome should be considered in the differential diagnosis of subacute, fast progressive gait disorders. © 2007 Movement Disorder Society
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DOI: 10.1002/mds.21371
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of Neurology, Institute of Neurosciences, Hospital Clínic i Universitari de Barcelona, Barcelona, Catalonia, Spain</mods:affiliation></affiliation></author><author><name sortKey="G Mez Ns N, Beatriz" sort="G Mez Ns N, Beatriz" uniqKey="G Mez Ns N B" first="Beatriz" last="G Mez-Ans N">Beatriz G Mez-Ans N</name><affiliation><mods:affiliation>Department of Radiology, Diagnostic Imaging Center, Hospital Clínic i Universitari de Barcelona, Barcelona, Catalonia, Spain</mods:affiliation></affiliation></author><author><name sortKey="Rami, Lorena" sort="Rami, Lorena" uniqKey="Rami L" first="Lorena" last="Rami">Lorena Rami</name><affiliation><mods:affiliation>Department of Neurology, Institute of Neurosciences, Hospital Clínic i Universitari de Barcelona, Barcelona, Catalonia, Spain</mods:affiliation></affiliation></author><author><name sortKey="Tolosa, Eduardo" sort="Tolosa, Eduardo" uniqKey="Tolosa E" first="Eduardo" last="Tolosa">Eduardo Tolosa</name><affiliation><mods:affiliation>Department 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We report a 69‐year‐old man presenting with a three‐month isolated, progressive gait disorder with normal neurological examination, except for loss of balance and gait failure reminding frontal disequilibrium, only accompanied by a very mild rigidity of his right foot. MRI of the brain showed hyperintensities in both amygdale and left putamen. EMG study showed no abnormal continuous spontaneous fiber activity. Because of fast progression and MRI findings, anti‐Hu antibodies were tested, resulting positive. Mediastinal biopsy of two adenopathies detected by body‐PET, confirmed an oat‐cell carcinoma. The patient received oral steroids and oncological therapy. One year later, the tumor is in remission. His gait and abnormal posture of right leg are normal. Only mild residual hyperintensities persist on follow‐up MRI. A paraneoplastic syndrome should be considered in the differential diagnosis of subacute, fast progressive gait disorders. © 2007 Movement Disorder Society</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Yaroslau Compta MD</name><affiliations><json:string>Department of Neurology, Institute of Neurosciences, Hospital Clínic i Universitari de Barcelona, Barcelona, Catalonia, Spain</json:string></affiliations></json:item><json:item><name>Francesc Valldeoriola MD, PhD</name><affiliations><json:string>Department of Neurology, Institute of Neurosciences, Hospital Clínic i Universitari de Barcelona, Barcelona, Catalonia, Spain</json:string></affiliations></json:item><json:item><name>Xabier Urra MD</name><affiliations><json:string>Department of Neurology, Institute of Neurosciences, Hospital Clínic i Universitari de Barcelona, Barcelona, Catalonia, Spain</json:string></affiliations></json:item><json:item><name>Beatriz Gómez‐Ansón MD, PhD</name><affiliations><json:string>Department of Radiology, Diagnostic Imaging Center, Hospital Clínic i Universitari de Barcelona, Barcelona, Catalonia, Spain</json:string></affiliations></json:item><json:item><name>Lorena Rami PhD</name><affiliations><json:string>Department of Neurology, Institute of Neurosciences, Hospital Clínic i Universitari de Barcelona, Barcelona, Catalonia, Spain</json:string></affiliations></json:item><json:item><name>Eduardo Tolosa MD, FRCP</name><affiliations><json:string>Department of Neurology, Institute of Neurosciences, Hospital Clínic i Universitari de Barcelona, Barcelona, Catalonia, Spain</json:string></affiliations></json:item><json:item><name>Francesc Graus MD, PhD</name><affiliations><json:string>Department of Neurology, Institute of Neurosciences, Hospital Clínic i Universitari de Barcelona, Barcelona, Catalonia, Spain</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>gait failure</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>frontal disequilibrium</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>anti‐Hu antibodies</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>paraneoplastic encephalomyelitis</value></json:item></subject><language><json:string>eng</json:string></language><abstract>Anti‐Hu encephalomyelitis is one of the most frequent paraneoplastic syndromes, classically presenting with diffuse neurological involvement. We report a 69‐year‐old man presenting with a three‐month isolated, progressive gait disorder with normal neurological examination, except for loss of balance and gait failure reminding frontal disequilibrium, only accompanied by a very mild rigidity of his right foot. MRI of the brain showed hyperintensities in both amygdale and left putamen. EMG study showed no abnormal continuous spontaneous fiber activity. Because of fast progression and MRI findings, anti‐Hu antibodies were tested, resulting positive. Mediastinal biopsy of two adenopathies detected by body‐PET, confirmed an oat‐cell carcinoma. The patient received oral steroids and oncological therapy. One year later, the tumor is in remission. His gait and abnormal posture of right leg are normal. Only mild residual hyperintensities persist on follow‐up MRI. 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A paraneoplastic syndrome should be considered in the differential diagnosis of subacute, fast progressive gait disorders. © 2007 Movement Disorder Society</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>Keywords</head><item><term>gait failure</term></item><item><term>frontal disequilibrium</term></item><item><term>anti‐Hu antibodies</term></item><item><term>paraneoplastic encephalomyelitis</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>Article category</head><item><term>Brief Report</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2006-11-15">Received</change><change when="2006-11-19">Registration</change><change when="2007-04-15">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/35A1CF54D16CC5ED4771083CC98F6EC643FB4198/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Wiley Subscription Services, Inc., A Wiley Company</publisherName><publisherLoc>Hoboken</publisherLoc></publisherInfo><doi registered="yes">10.1002/(ISSN)1531-8257</doi><issn type="print">0885-3185</issn><issn type="electronic">1531-8257</issn><idGroup><id type="product" value="MDS"></id></idGroup><titleGroup><title type="main" xml:lang="en" sort="MOVEMENT DISORDERS">Movement Disorders</title><title type="short">Mov. 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affiliationRef="#af1"><personName><givenNames>Francesc</givenNames><familyName>Graus</familyName><degrees>MD, PhD</degrees></personName></creator></creators><affiliationGroup><affiliation xml:id="af1" countryCode="ES" type="organization"><unparsedAffiliation>Department of Neurology, Institute of Neurosciences, Hospital Clínic i Universitari de Barcelona, Barcelona, Catalonia, Spain</unparsedAffiliation></affiliation><affiliation xml:id="af2" countryCode="ES" type="organization"><unparsedAffiliation>Department of Radiology, Diagnostic Imaging Center, Hospital Clínic i Universitari de Barcelona, Barcelona, Catalonia, Spain</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en" type="author"><keyword xml:id="kwd1">gait failure</keyword><keyword xml:id="kwd2">frontal disequilibrium</keyword><keyword xml:id="kwd3">anti‐Hu antibodies</keyword><keyword xml:id="kwd4">paraneoplastic encephalomyelitis</keyword></keywordGroup><supportingInformation><p> This article includes supplementary video clips, available online at <url href="http://www.interscience.wiley.com/jpages/0885-3185/suppmat"> http://www.interscience.wiley.com/jpages/0885‐3185/suppmat. </url></p><supportingInfoItem><mediaResource alt="supporting information" href="urn-x:wiley:08853185:media:mds21371:jws-mds"></mediaResource><caption>Segment 1. Loss of balance (falling backwards) and disorganization of trunk and leg movements dominate patient's gait pattern. The patient needs help of a person and a crutch to walk, with a short‐stepped and mildly wide‐based gait, as well as a slightly adducted, inverted posture of his right foot.Segment 2. The patient, with his tumor in remission, features normal gait and no abnormal posturing of his right leg.</caption></supportingInfoItem></supportingInformation><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><p>Anti‐Hu encephalomyelitis is one of the most frequent paraneoplastic syndromes, classically presenting with diffuse neurological involvement. We report a 69‐year‐old man presenting with a three‐month isolated, progressive gait disorder with normal neurological examination, except for loss of balance and gait failure reminding frontal disequilibrium, only accompanied by a very mild rigidity of his right foot. MRI of the brain showed hyperintensities in both amygdale and left putamen. EMG study showed no abnormal continuous spontaneous fiber activity. Because of fast progression and MRI findings, anti‐Hu antibodies were tested, resulting positive. Mediastinal biopsy of two adenopathies detected by body‐PET, confirmed an oat‐cell carcinoma. The patient received oral steroids and oncological therapy. One year later, the tumor is in remission. His gait and abnormal posture of right leg are normal. Only mild residual hyperintensities persist on follow‐up MRI. A paraneoplastic syndrome should be considered in the differential diagnosis of subacute, fast progressive gait disorders. © 2007 Movement Disorder Society</p></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><!--Version 0.6 générée le 3-12-2015--><mods version="3.6"><titleInfo lang="en"><title>Isolated frontal disequilibrium as presenting form of anti‐Hu paraneoplastic encephalomyelitis</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Frontal Disequilibrium as Presenting Form of PEM</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Isolated frontal disequilibrium as presenting form of anti‐Hu paraneoplastic encephalomyelitis</title></titleInfo><name type="personal"><namePart type="given">Yaroslau</namePart><namePart type="family">Compta</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurology, Institute of Neurosciences, Hospital Clínic i Universitari de Barcelona, Barcelona, Catalonia, Spain</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Francesc</namePart><namePart type="family">Valldeoriola</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Department of Neurology, Institute of Neurosciences, Hospital Clínic i Universitari de Barcelona, Barcelona, Catalonia, Spain</affiliation><description>Correspondence: Department of Neurology, Institut de Neurociències, Hospital Clínic i Universitari de Barcelona, C/ Villarroel, 170, 08036‐Barcelona, Catalonia, Spain</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Xabier</namePart><namePart type="family">Urra</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurology, Institute of Neurosciences, Hospital Clínic i Universitari de Barcelona, Barcelona, Catalonia, Spain</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Beatriz</namePart><namePart type="family">Gómez‐Ansón</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Department of Radiology, Diagnostic Imaging Center, Hospital Clínic i Universitari de Barcelona, Barcelona, Catalonia, Spain</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Lorena</namePart><namePart type="family">Rami</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Department of Neurology, Institute of Neurosciences, Hospital Clínic i Universitari de Barcelona, Barcelona, Catalonia, Spain</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Eduardo</namePart><namePart type="family">Tolosa</namePart><namePart type="termsOfAddress">MD, FRCP</namePart><affiliation>Department of Neurology, Institute of Neurosciences, Hospital Clínic i Universitari de Barcelona, Barcelona, Catalonia, Spain</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Francesc</namePart><namePart type="family">Graus</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Department of Neurology, Institute of Neurosciences, Hospital Clínic i Universitari de Barcelona, Barcelona, Catalonia, Spain</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre authority="originalCategForm">article</genre><originInfo><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><place><placeTerm type="text">Hoboken</placeTerm></place><dateIssued encoding="w3cdtf">2007-04-15</dateIssued><dateCaptured encoding="w3cdtf">2006-11-15</dateCaptured><dateValid encoding="w3cdtf">2006-11-19</dateValid><copyrightDate encoding="w3cdtf">2007</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">1</extent><extent unit="references">10</extent><extent unit="words">1981</extent></physicalDescription><abstract lang="en">Anti‐Hu encephalomyelitis is one of the most frequent paraneoplastic syndromes, classically presenting with diffuse neurological involvement. We report a 69‐year‐old man presenting with a three‐month isolated, progressive gait disorder with normal neurological examination, except for loss of balance and gait failure reminding frontal disequilibrium, only accompanied by a very mild rigidity of his right foot. MRI of the brain showed hyperintensities in both amygdale and left putamen. EMG study showed no abnormal continuous spontaneous fiber activity. Because of fast progression and MRI findings, anti‐Hu antibodies were tested, resulting positive. Mediastinal biopsy of two adenopathies detected by body‐PET, confirmed an oat‐cell carcinoma. The patient received oral steroids and oncological therapy. One year later, the tumor is in remission. His gait and abnormal posture of right leg are normal. Only mild residual hyperintensities persist on follow‐up MRI. A paraneoplastic syndrome should be considered in the differential diagnosis of subacute, fast progressive gait disorders. © 2007 Movement Disorder Society</abstract><subject lang="en"><genre>Keywords</genre><topic>gait failure</topic><topic>frontal disequilibrium</topic><topic>anti‐Hu antibodies</topic><topic>paraneoplastic encephalomyelitis</topic></subject><relatedItem type="host"><titleInfo><title>Movement Disorders</title></titleInfo><titleInfo type="abbreviated"><title>Mov. Disord.</title></titleInfo><note type="content"> This article includes supplementary video clips, available online at http://www.interscience.wiley.com/jpages/0885‐3185/suppmat.Supporting Info Item: Segment 1. Loss of balance (falling backwards) and disorganization of trunk and leg movements dominate patient's gait pattern. The patient needs help of a person and a crutch to walk, with a short‐stepped and mildly wide‐based gait, as well as a slightly adducted, inverted posture of his right foot.Segment 2. The patient, with his tumor in remission, features normal gait and no abnormal posturing of his right leg. - </note><subject><genre>article category</genre><topic>Brief Report</topic></subject><identifier type="ISSN">0885-3185</identifier><identifier type="eISSN">1531-8257</identifier><identifier type="DOI">10.1002/(ISSN)1531-8257</identifier><identifier type="PublisherID">MDS</identifier><part><date>2007</date><detail type="volume"><caption>vol.</caption><number>22</number></detail><detail type="issue"><caption>no.</caption><number>5</number></detail><extent unit="pages"><start>736</start><end>738</end><total>3</total></extent></part></relatedItem><identifier type="istex">35A1CF54D16CC5ED4771083CC98F6EC643FB4198</identifier><identifier type="DOI">10.1002/mds.21371</identifier><identifier type="ArticleID">MDS21371</identifier><accessCondition type="use and reproduction" contentType="copyright">Copyright © 2007 Movement Disorder Society</accessCondition><recordInfo><recordOrigin>Wiley Subscription Services, Inc., A Wiley Company</recordOrigin><recordContentSource>WILEY</recordContentSource></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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