NCCS Successfully Treats Rare Neurological Complications from Cancer
 Two young patients suffering from paraneoplastic encephalitis, an inflammation of the brain associated with ovarian tumours, were successfully treated with aggressive chemotherapy, at the National Cancer Centre Singapore (NCCS).
In the management of these two cases, NCCS highlighted in medical journals the importance of prompt and aggressive chemotherapy in the treatment of this unusual and disabling, yet potentially reversible problem, in young women, in addition to conventional surgery.
Paraneoplastic encephalitis, an acute inflammation of the brain is the result of the presence of cancer in the body causing the immune system to mistakenly attack the brain through an antibody called the anti-NMDA antibody. For both patients, who were referred to NCCS, the cause was tumours in the ovaries.
Dr Tan Min-Han, Associate Consultant, Dept of Medical Oncology, NCCS noted, “It is important to recognise this severe inflammation of the brain in young women, where neurological symptoms can be easily mistakenly attributed to many other causes rather than ovarian tumours or cyst. With prompt treatment, the chance of a
complete recovery is high.“
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Three years ago, Ms Dewi Hermawati came down with a bout of fits, fever and confusion, which persisted after a month of investigation and therapy for multiple possible causes. After a cyst in the left ovary was found, a presumptive diagnosis of encephalitis was made and surgery recommended.
As her symptoms continued for weeks after surgery, doctors at NCCS decided to proceed with aggressive chemotherapy even though all tumours had been removed by surgery. Ms Dewi’s condition improved rapidly upon administration of the first cycle. Twenty days after the start of chemotherapy, she regained orientation and responded appropriately to questions and was well enough to return to work, after four months, upon completion of chemotherapy. Today, she is completely cured of her condition.
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