Neurological autoimmunity in patients with non-pulmonary neuroendocrine neoplasms: clinical manifestations and neural autoantibody profiles.

Background And Purpose: Paraneoplastic neurological autoimmunity is well described with small-cell lung cancer, but information is limited for other neuroendocrine neoplasms (NENs).

Methods: Adult patients with histopathologically confirmed non-pulmonary NENs, neurological autoimmunity within 5 years of NEN diagnosis, and neural antibody testing performed at the Mayo Clinic Neuroimmunology Laboratory (January 2008 to March 2023) were retrospectively identified. Control sera were available from patients with NENs without neurological autoimmunity (116).

Systematic approach to diagnosing suspected Creutzfeldt-Jakob disease.

Evaluation of rapidly progressive dementia (RPD) is usually challenging. In most cases, patients progress to dementia in weeks to months, and the differential diagnosis is broad. In this case, a woman in her 60s presented with a 1-month history of episodic vertigo, cognitive decline, ataxia and myoclonus.

Subacute Horizontal Diplopia, Jaw Dystonia, and Laryngospasm.

Jaw dystonia and laryngospasm in the context of subacute brainstem dysfunction have been described in a small number of diseases, including antineuronal nuclear antibody type 2 (ANNA-2, also known as anti-Ri) paraneoplastic neurologic syndrome. Severe episodes of laryngospasms causing cyanosis are potentially fatal. Jaw dystonia can also cause eating difficulty, resulting in severe weight loss and malnutrition.

Alzheimer's disease cerebrospinal fluid biomarkers differentiate patients with Creutzfeldt-Jakob disease and autoimmune encephalitis.

Background And Purpose: Autoimmune encephalitis (AE) is a potentially treatable cause of rapidly progressive dementia that may mimic Creutzfeldt-Jakob disease (CJD). Alzheimer disease (AD) cerebrospinal fluid (CSF) biomarkers may discriminate CJD from AD, but utility in discriminating CJD and AE is unclear. This study compared AD CSF biomarkers in CJD and AE.

A Rare Presentation of Central Nervous System Tuberculomas in an Immunocompetent Patient.

The uncommon presentation of simultaneous brain and lung lesions in an immunocompetent adult patient with frequent travel to a mycobacterium tuberculosis (MTB) endemic area requires high clinical suspicion for central nervous system (CNS) MTB, as this disease often results in severe neurologic morbidity and mortality. Non-specific and subacute symptoms make the diagnosis of CNS MTB clinically challenging, and a workup with imaging and microbiological studies such as acid-fast bacilli staining, nucleic acid amplification testing, and tissue culture must not delay prompt treatment with anti-tuberculosis therapy. This case illustrates the complex challenges of medical diagnosis and multi-disciplinary decision-making involved in the workup of CNS MTB.

Neurologist Attitudes on Practicing in Hawai'i.

There is a shortage of neurologists nationwide, and the demand for neurologists is expected to increase in the upcoming years while the pool of practicing neurologists dwindles. Per Hawai'i Neurological Society, there were 44 practicing neurologists in the state of Hawai'i in 2019, representing a shortage of approximately 28 neurologists. Considering that Hawai'i is geographically, demographically, and culturally distinct compared to other states, a concern is that practicing neurology in Hawai'i poses unique challenges that may contribute to the low numbers of neurologists.