Encephalite limbique paraneoplasique, un syndrome mal connu : A propos d’un cas a Lome (Togo)

Introduction : Les encephalites limbiques pures sont des complications rares des cancers. Elles affectent aussi bien les hommes que les femmes. La tumeur associee est le plus souvent un cancer du poumon a petites cellules.Cas clinique : Nous rapportons le cas d‘un patient de 78 ans, tabagique actif, hospitalise pour un trouble de comportement a type d‘agressivite verbale avec propos incoherents dans un contexte d‘amaigrissement et d‘asthenie d‘aggravation progressive. L‘examen clinique retrouvait une amnesie anterograde avec des fabulations associees a une adenopathie sus claviculaire droite. Les explorations paracliniques ont permis de retrouver un carcinome pulmonaire avec a l‘IRM encephalique, un hypersignal T2 dans la region  hippocampique gauche permettant de poser le diagnostic d‘encephalite limbique paraneoplasique. L‘evolution sous chimiotherapie et radiotherapie a ete favorable.Conclusion : L‘encephalite limbique paraneoplasique constitue une entite rare et merite d‘etre suspectee au meme titre que les autres causes d‘encephalopathies. English title: Paraneoplastic limbic encephalitis, a badly known syndrome: A case report in Lome (Togo) Background: Pure limbic encephalitides are unusual complications of cancers. Both men and women can be affected. The associated tumor is most often a small cell lung cancer.Case report: We reported the case of a 78-year-old patient who was an active tobacco addict. He was hospitalized for a behavioral disorder  like verbal aggression with incoherent speech in a context of progressive weight loss and asthenia. Clinical examination revealed anterograde amnesia with confabulations associated with right supraclavicular lymphadenopathy. Paraclinical explorations revealed a pulmonary carcinoma with at MRI, a T2 hypersignal in the left hippocampal region.Therefore, the diagnosis of paraneoplastic limbic encephalitis has been made. The evolution with chemotherapy and radiotherapy was favorable.Conclusion: Limbic paraleoplastic encephalitis is a rare clinical entity and should be rouled out during a work-up for every case of encephalitis.