This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Paraneoplastic encephalomyelitis and subacute sensory neuronopathy are uncommon complications of systemic malignancy, usually small-cell lung carcinoma. Both are associated with a specific antineuronal antibody response, designated by different groups as anti-Hu, [1] ANNA-1, [2] and type IIa. [3] When the clinical components of paraneoplastic encephalomyelitis and subacute sensory neuronopathy occur together, the syndrome has been referred to as paraneoplastic encephalomyeloneuritis (PEMN). [4] PEMN is often difficult to recognize early in its course, particularly before detection of the underlying neoplasm. Antineuronal antibody testing has greatly facilitated diagnosis when a paraneoplastic disorder is suspected. A patient who presented in coma after cardiac arrest with pulseless electrical activity escaped premortem diagnosis because a paraneoplastic etiology was not considered.
Case report.
A 71-year-old man presented to the University of Virginia Health Sciences Center after cardiac arrest. He had been treated for hypertension, coronary artery disease, and abdominal aortic aneurysm in the past. He had undergone successful coronary artery bypass surgery after a myocardial infarction 2 years previously and was healthy, asymptomatic, and planning for marriage. Three weeks before admission, he complained of malaise. Over the next 2 weeks, his family recalled decreased interaction, poor appetite with mild weight loss, gait unsteadiness, and slurred speech.
On the day of admission, he suddenly …
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
Letters: Rapid online correspondence
REQUIREMENTS
You must ensure that your Disclosures have been updated within the previous six months. Please go to our Submission Site to add or update your Disclosure information.
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.
