{
  "abstract": "CCPD is an extremely rare, heterogenous condition causing simultaneous demyelination in the Central Nervous System (CNS) and Peripheral Nervous system (PNS). It often causes a severe, treatment refractory syndrome with a high degree of morbidity.We present a 56 year old with a locally advanced gastric cancer with curative resection 6 months prior. He developed mild, brief, head nodding seizures with a short electrographic seizure captured on EEG, arising out of the left anterior lobe. Contrary to his mild phenotype, his outpatient MRI Brain performed 10 days later demonstrated profound bilateral mesial temporal lobe hyperintensity and enhancement. He was admitted for cerebrospinal fluid testing which was markedly inflammatory without infection or malignancy seen. On review, he had a new profound sensorimotor dysfunction with brisk reflexes. MRI whole cord was unremarkable but his cauda equina demonstrated leptomeningeal enhancement. NCS demonstrated mildly prolonged F-M latencies only and EMG with very mild spontaneous activity only. He was diagnosed with CCPD. He commenced treatment with IVIg and IVMP with good effect before then developing diabetes insipidus. He then returned strongly positive serum and CSF Anti Ma/Ta antibodies. His serial CT panscan and PET’s have been normal without current sign of malignancy, but remains under ongoing surveillance. Clinically, he has had multiple PNS relapses with progressive demyelinating and axonal changes on NCS, requiring upescalation of therapies to include PLEX, Rituximab and Cyclophosphamide with significant morbidity.This case highlights the diagnostic and treatment challenges for CCPD.",
  "authors": [
    {
      "affiliations": [
        "Neurology, Royal Brisbane and Women’s Hospital, Brisbane, QLD, Australia"
      ],
      "name": "John Girgis"
    },
    {
      "affiliations": [
        "Neurology, Sunshine Coast University Hospital, Sunshine Coast, QLD, Australia",
        "Griffith University, QLD, Australia"
      ],
      "name": "Antony Winkel"
    },
    {
      "affiliations": [
        "Neurology, Sunshine Coast University Hospital, Sunshine Coast, QLD, Australia",
        "Griffith University, QLD, Australia"
      ],
      "name": "Andrew Clarke"
    }
  ],
  "title": "3689 A combined central and peripheral demyelinating (CCPD) syndrome secondary to anti Ma/Ta",
  "uid": "69fe4c8c-1fce-5b58-bee7-98b44d1fd32b"
}