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Broadley J, Blazé R. Generalized and orofacial choreoathetosis: a case report of anti-CV2 paraneoplastic syndrome after cardiac arrest. Neurocase 2021; 27:72-75. [PMID: 33356843 DOI: 10.1080/13554794.2020.1866615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
CV2/CRMP5 is the most common antibody accompaniment of paraneoplastic choreoathetosis. We present a case of paraneoplastic choreothetosis with associated cerebellar dysfunction, peripheral neuropathy, and likely dysautonomia. Our patient developed a movement disorder after a cardiopulmonary arrest, which unfortunately masked the true etiology of his symptoms. He was later found to have extensive stage small cell lung cancer, with further evaluation revealing seropositivity for anti-CV2 antibodies. Choreoathetosis is a known sequelae of hypoxic-ischemic brain injury, but clinicians should continue to keep an open mind. The utility of immunotherapy is unclear in these circumstances and many physicians adopt a symptom-based approach.
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Affiliation(s)
- James Broadley
- Department of Neuroscience, Monash University, Melbourne, Australia.,Department of Neuroscience, Alfred Health, Melbourne, Australia
| | - Richard Blazé
- Department of Neuroscience, Alfred Health, Melbourne, Australia
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Ha J, Na BS, Ahn JH, Kim M, Kim JW, Lee JH, Cho JW, Kim JS, Youn J. Anti-CV2/CRMP5 Paraneoplastic Chorea Effectively Managed with Intravenous Amantadine. Tremor Other Hyperkinet Mov (N Y) 2019; 9:tre-09-701. [PMID: 31656691 PMCID: PMC6790010 DOI: 10.7916/tohm.v0.701] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 09/16/2019] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Paraneoplastic chorea is typically a subacute progressive hyperkinetic movement disorder. The mainstay of treatment is managing the underlying neoplasm. However, the clinical course may be variable, and effective symptomatic management can precede the start of cancer treatment. CASE REPORT A 63-year-old man presented with insidious onset, slowly progressive generalized chorea for 1 year, later diagnosed as anti-CV2/CRMP5 autoantibody positive paraneoplastic chorea. His chorea was markedly improved with intravenous amantadine. DISCUSSION In patients with anti-CV2/CRMP5 autoantibody-related chorea, sequential follow-up of brain magnetic resonance imaging reveals progression from active inflammation to atrophy. Our report highlights the efficacy of intravenous amantadine in paraneoplastic chorea.
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Affiliation(s)
- Jongmok Ha
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, KR,Neuroscience Center, Samsung Medical Center, Seoul, KR
| | - Boo Suk Na
- Department of Neurology, Dongshin Hospital, Seoul, KR
| | - Jong Hyeon Ahn
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, KR,Neuroscience Center, Samsung Medical Center, Seoul, KR
| | - Minkyeong Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, KR,Neuroscience Center, Samsung Medical Center, Seoul, KR
| | - Jae Woo Kim
- Department of Neurology, Dong-A University College of Medicine, Busan, KR
| | - Jae Hyeok Lee
- Department of Neurology, Pusan National University Yangsan Hospital, Yangsan, KR
| | - Jin Whan Cho
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, KR,Neuroscience Center, Samsung Medical Center, Seoul, KR
| | - Ji Sun Kim
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, KR,Neuroscience Center, Samsung Medical Center, Seoul, KR
| | - Jinyoung Youn
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, KR,Neuroscience Center, Samsung Medical Center, Seoul, KR,To whom correspondence should be addressed. E-mail:
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Fang Z, Yang Y, Chen X, Zhang W, Xie Y, Chen Y, Liu Z, Yuan W. Advances in Autoimmune Epilepsy Associated with Antibodies, Their Potential Pathogenic Molecular Mechanisms, and Current Recommended Immunotherapies. Front Immunol 2017; 8:395. [PMID: 28487693 PMCID: PMC5403900 DOI: 10.3389/fimmu.2017.00395] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Accepted: 03/21/2017] [Indexed: 01/17/2023] Open
Abstract
In this comprehensive article, we present an overview of some most common autoimmune antibodies believed to be potentially pathogenic for autoimmune epilepsies and elaborate their pathogenic mode of action in molecular levels based on the existing knowledge. Findings of the studies of immunemodulatory treatments for epilepsy are also discussed, and guidelines for immunotherapy are sorted out. We aim to summarize the emerging understanding of different pathogenic mechanisms of autoantibodies and clinical immunotherapy regimens to open up therapeutic possibilities for future optimum therapy. We conclude that early diagnosis of autoimmune epilepsy is of great significance, as early immune treatments have useful disease-modifying effects on some epilepsies and can facilitate the recovery.
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Affiliation(s)
- Zhiwei Fang
- Department of Neurology, Xinhua Hospital Affiliated to the Medical School of Shanghai Jiao Tong University, Shanghai, China.,School of Pharmacy, Shanghai Jiao Tong University, Shanghai, China
| | - Yunqi Yang
- School of Pharmacy, Shanghai Jiao Tong University, Shanghai, China.,Zhiyuan College, Shanghai Jiao Tong University, Shanghai, China
| | - Xuan Chen
- School of Pharmacy, Shanghai Jiao Tong University, Shanghai, China
| | - Weiwang Zhang
- School of Pharmacy, Shanghai Jiao Tong University, Shanghai, China
| | - Yangmei Xie
- Department of Neurology, Jinshan Hospital, Fudan University, Shanghai, China
| | - Yinghui Chen
- Department of Neurology, Jinshan Hospital, Fudan University, Shanghai, China
| | - Zhenguo Liu
- Department of Neurology, Xinhua Hospital Affiliated to the Medical School of Shanghai Jiao Tong University, Shanghai, China
| | - Weien Yuan
- School of Pharmacy, Shanghai Jiao Tong University, Shanghai, China
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Goldstein L, Djaldetti R, Benninger F. Anti-Yo, chorea and hemiballismus: A case report. J Clin Neurosci 2017; 42:113-114. [PMID: 28372903 DOI: 10.1016/j.jocn.2017.03.045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Accepted: 03/13/2017] [Indexed: 10/19/2022]
Abstract
68-year-old female presented with involuntary movements. MRI was normal. Cerebrospinal fluid analysis was normal. whole body CT and biopsy confirmed diagnosis of metastatic adenocarnimoa. The autoimmune panel was positive for anti-Yo antibodies.
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Affiliation(s)
- Lilach Goldstein
- Department of Neurology, Rabin Medical Center, Campus Beilinson, Petach Tiqwa, Israel.
| | - Ruth Djaldetti
- Department of Neurology, Rabin Medical Center, Campus Beilinson, Petach Tiqwa, Israel.
| | - Felix Benninger
- Department of Neurology, Rabin Medical Center, Campus Beilinson, Petach Tiqwa, Israel.
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