ACD 09/23/14HARJOT KAUR PGY 3

Antibody-associated disorders of the central nervous system

Classic paraneoplastic disorders (PNDs)

Autoimmune encephalitis

PND relatively rare

always associated with a systemic cancer

affect older adults

Antibodies target intracellular neuronal antigens

mediated by cytotoxic T-cell responses

a monophasic clinical course

limited response to treatment

Autoimmune encephalitis

more common

with and without a cancer association

wider age range

Direct interaction with the target antigens

responsive to treatment

Target : Antigens - neuronal cell-surface proteins or synaptic receptors

Treatment:

First line:

Corticosteroids

intravenous immunoglobulin

plasma exchange

Second-line immunotherapy

Rituximab/ cyclophosphamide/or both

Neuro-Oncology 16(6), 771–778, 2014

UPTODATE