{
  "abstract": "Background Anti-Hu is a paraneoplastic syndrome which presents with sensory neuropathy, but can have a pleomorphic presentation of limbic encephalitis, brainstem encephalitis, autonomic dysfunction and motor neuropathy. It is strongly associated with small cell lung cancer.Case A 78 year old previously independent ex-truck driver was admitted with a two month history of bilateral lower limb paraesthesia and weakness. He had no significant past medical history, but a 50 pack year smoking history. Initial MRI brain was normal, and MRI of the whole spine demonstrated no spinal cord compression. He subsequently developed confusion, focal seizures, ascending weakness, sensory loss to the level of T10, and loss of lower limb reflexes. CSF demonstrated elevated white cells of 40x10^6, protein of 2.58g/L, and negative meningitic panel. Serum and CSF studies for Anti-Hu were positive. Repeat MRI Brain demonstrated bilateral medial temporal lobe T2 hyperintensity, consistent with limbic encephalitis. PET scan demonstrated avid hilar and mediastinal lymphadenopathy, which was biopsied via endobronchial ultrasound, confirming a diagnosis of small cell lung cancer. He was treated with methylprednisolone, IVIG and levetiracetam, which terminated seizures and improved his confusional state. On the basis of his pre-morbid function, systemic chemotherapy was trialled, but he passed away from aspiration pneumonia several weeks after commencement of chemotherapy.Conclusion The prognosis of Anti-Hu paraneoplastic encephalitis is poor. Diagnosis should prompt investigation for underlying malignancy.",
  "authors": [
    {
      "affiliations": [
        "Royal Prince Alfred Hospital, Camperdown, NSW, Australia"
      ],
      "name": "Jeremy Qiao"
    },
    {
      "affiliations": [
        "Liverpool Hospital, Liverpool, NSW, Australia"
      ],
      "name": "Patrick Goorkiz"
    },
    {
      "affiliations": [
        "Liverpool Hospital, Liverpool, NSW, Australia"
      ],
      "name": "Neil Griffith"
    }
  ],
  "title": "3659 Anti-hu paraneoplastic encephalitis and small cell lung cancer: a case report",
  "uid": "65c6a7a4-9959-552b-86bf-05cb978b508e"
}