Article Text

PDF
Paraneoplastic neuropsychiatric syndrome presenting as delirium
  1. Gloria Roldan Urgoiti1,
  2. Aynharan Sinnarajah2,3,
  3. Seema Hussain2,4 and
  4. Desiree Hao1
  1. 1Division of Medical Oncology, Department of Oncology, Faculty of Medicine, Tom Baker Cancer Centre, University of Calgary, Calgary, Alberta, Canada
  2. 2Division of Palliative Medicine, Department of Oncology, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada
  3. 3Palliative & End of Life Care, Alberta Health Services (AHS), Calgary Zone, Calgary, Alberta, Canada
  4. 4Department of Psychiatry, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada
  1. Correspondence to Dr Desirée Hao, Division of Medical Oncology, Department of Oncology, Faculty of Medicine, Tom Baker Cancer Centre, University of Calgary, 1331 29th St NW, Calgary, Alberta, Canada T2N 4N2; Desiree.Hao@albertahealthservices

Abstract

Delirium in patients with cancer is associated with poor outcomes, but reversible causes need to be ruled out. We report the case of a 59-year-old woman who was presented with behavioural and cognitive changes over 2 weeks. She was non-verbal and combative, requiring involuntary admission and declaration of incompetence to make healthcare treatment decisions. Infectious and metabolic investigations and initial brain imaging were unremarkable. She was diagnosed with limited-stage small cell lung cancer and a paraneoplastic neuropsychiatric syndrome. Owing to the patient's delirium, chemotherapy delivery required pharmacological and physical restraints. After 2 cycles of chemotherapy, she could participate in the decision process and was discharged home. She completed radical chemo-radiotherapy and has remained free of disease progression for 18 months. Paraneoplastic neuropsychiatric syndromes, although rare, are potentially treatable and need to be excluded as a cause of delirium.

  • case report
  • small cell lung cancer
  • Paraneoplastic syndrome
  • Received 3 November 2015.
  • Revision received 20 May 2016.
  • Accepted 14 July 2016.

Statistics from Altmetric.com

  • Received 3 November 2015.
  • Revision received 20 May 2016.
  • Accepted 14 July 2016.
View Full Text

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.