Encéphalites limbiques paranéoplasiques de l’enfant : à propos de 2 observations

Neurological Complications of Childhood Cancer

Though the treatment of pediatric cancers has come a long way, acute and chronic effects of cancer are still affecting the life of many children. These effects may be caused not only by the malignancy itself but also by the interventions used for the purpose of treatment. This article focuses primarily on the indirect effects of pediatric cancers and their treatment on the central and peripheral nervous system. Chemotherapy, radiation, and stem cell transplantation cause an immune-compromised state and place the patient at risk of infection, the leading cause of mortality in pediatric cancer. The underlying cancer and the treatments also cause neurovascular changes that may lead to neurological sequelae immediately or many years in the future. Chemotherapy and radiation have both immediate and long-term neurotoxic effects on the central and peripheral nervous system. Cancers may also trigger an immune response that damages nervous system components, leading to altered mental status, seizures, abnormal movements, and even psychosis. Knowledge of these effects can help the practitioner be more vigilant for the signs and symptoms of potential neurological complications during the management of pediatric cancers.

Two cases of paraneoplastic limbic encephalitis associated with small cell lung cancer and a literature review

In the present study, two cases of paraneoplastic limbic encephalitis (PLE) associated with small cell lung cancer were reported. Using avidin-biotin immunoperoxidase methods, purified recombinant HuD western blotting and Euroline Neuronal Antigens Profile 2 immunoglobulin G western blotting, it was found that the well-characterized anti-Hu and anti-amphiphysin onconeuronal antibodies were present in the serum/cerebrospinal fluid of the patients. With a review of the literature, it was found that patients with PLE of Chinese Han nationality had two types of clinical manifestations, simple and complex, and that the lesions could also be divided into focal and scalable lesions. Furthermore, the clinical manifestations and lesion scopes were associated with certain types of cancer and antibodies. In addition, it was found that the prognosis for patients with PLE with autoantibodies targeting membrane antigens is improved compared with that for patients with PLE with autoantibodies targeting intracellular antigens, due to an increased sensitivity to immunomodulatory treatments and anti-cancer therapy.

Paraneoplastic neurological syndromes in Hodgkin and non-Hodgkin lymphomas

Paraneoplastic neurological syndromes (PNSs) rarely associate with Hodgkin lymphoma (HL) and non-HLs (NHLs). Except for paraneoplastic cerebellar degeneration (PCD) in HL and dermato/ polymyositis in both HL and NHL, other PNSs are uncommon and have only been reported as isolated case reports or short series. There are several important differences in PNSs when occurring in association with HL and NHL compared with those associated with solid tumors. First, some PNSs such as sensory neuronopathy or Lambert-Eaton myasthenic syndrome rarely occur in lymphomas, whereas others, such as granulomatous angiitis, are only described in HL. Second, onconeural antibodies are absent in most PNSs associated with lymphomas with the exceptions of Tr (δ/notch-like epidermal growth factor-related receptor) in PCD and mGluR5 in limbic encephalitis (LE). The antigens recognized by these antibodies are not expressed in lymphoma cells, suggesting the tumor itself does not trigger the PNS. Third, unlike patients with solid tumors in patients with lymphoma, the PNSs often develops at advanced stages of the disease. Furthermore, the type and frequency of PNSs are different between HL and NHL; whereas LE and PCD occur almost exclusively in patients with HL, sensorimotor neuropathies and dermatomyositis are more frequent in NHL.