Severe central and peripheral paraneoplastic demyelination associated with tumours of the ovaries

• DOI: 10.1007/s00381-015-2731-5
• Publication Date: 2015-05-12T10:24:46Z
• Authors: Elzbieta Jurkiewicz; Katarzyna Kotulska; Katarzyna Nowak; Katarzyna Malczyk; Julita Borkowska; Małgorzata Bilska
• Keywords: Acute disseminated encephalomyelitis; Paraneoplastic cerebellar degeneration; Neurological examination

The aim of the study is to present MRI examinations brain and spinal cord, performed in girls with acute severe neurological presentation paraneoplastic syndrome associated ovarian teratomas. Paraneoplastic (PNS) a rare disorder caused by remote effects malignancy different organs. pathogenesis PNS concerns autoimmune system specific antibodies. can be seen as encephalomyelitis, limbic encephalitis, progressive multifocal leukoencephalopathy, cerebellar ataxia, brainstem degeneration. These symptoms are potentially reversible, if underlying neoplasm removed.We presented three girls, aged 13, 17, 18 years. They were all referred hospital because an onset disseminated encephalomyelitis. All exams on 1.5 T scanner routine cord protocol, including TSE T2-WI FLAIR sequences. In cases, contrast agent was injected standard dose.Neurological examination at disease revealed hemiparesis, seizures, consciousness disturbances. one girl, visual field loss also disclosed. healthy before disease. Brain MR imaging multiple hyperintense lesions located supratentorially white matter both hemispheres, pons, cerebellum, cord. Patients treated methyloprednisolone IV IVIG. improved but significant sequelae present. Two them developed demyelinating polyradiculoneuropathy within 2 months after At same time, showed progression lesions. two patients, anti-Yo antibodies blood. Extensive bilateral teratomas left-sided teratoma case. Surgical resection resulted rapid clinical improvement.These cases show that children adolescents, manifestation syndrome. Thus, should always considered differential diagnosis female adolescents suspected PNS, it important search for tumours.