Neurocognitive deficits in a patient with small cell lung cancer: a case report

Kanan H Hudhud, Ashiq Masood, Yun Oh, AZ Hegazi

The neurocognitive deficits associated with small cell lung cancer include metastasis to brain and paraneoplastic syndrome. The patients are also predisposed to herpes encephalitis due to immunosuppression and chemotherapy. We report a case of 72 year old female diagnosed with small cell lung cancer started with memory deficits, ataxia, vertigo, and hearing loss. The paraneoplastic work-up returned as anti-Hu antibody positive. The MRI brain showed area of edema and inflammation right medial temporal lobe as well as enhancement in the underlying meningi. Although PCR/HSV of CSF was negative, the patient was empirically treated with IV acyclovir and showed significant improvement and was discharged in good condition. The case highlights the importance of keeping broad minded approach in treating patients with serious malignant diseases. The case also call attention to the use of empiric therapy in possible life threatening diseases such as Herpes encephalitis.