Neuroimmunologic/Paraneoplastic
4 cases on autoimmune and paraneoplastic neurology pharmacology — anti-NMDAR encephalitis escalation timing, paraneoplastic cerebellar degeneration, LGI1-antibody encephalitis tapering, and Lambert-Eaton myasthenic syndrome — choose a case below to open its full multi-voice debate.
Twelve days into first-line immunotherapy for anti-NMDA receptor encephalitis, a patient's dyskinesias haven't budged — and the consensus threshold for adding a second immunosuppressive agent is landing in the same week as her teratoma resection.
A month of escalating immunotherapy for anti-Yo paraneoplastic cerebellar degeneration hasn’t produced any real change — and the mechanism behind that antibody’s own poor track record is exactly what the team now has to reckon with honestly.
A textbook-strong response to first-line immunotherapy for LGI1-antibody encephalitis still leaves his memory only partially recovered — a residual deficit the literature ties directly to relapse risk, right as the team reaches the standard point to begin tapering.
A new small-cell-lung-cancer-associated LEMS diagnosis with worsening bulbar symptoms runs straight into amifampridine’s labeled seizure contraindication — built on a single, self-limited seizure from fifty-seven years ago that nobody has had reason to revisit since.