Immune Checkpoint Inhibitor-Induced Limbic Encephalitis during Treatment with Atezolizumab in a Patient with Small-Cell Lung Cancer: A Case Report and Review of the Literature

Table 2

Details of cases of PNS induced by ICI in SCLC patients.

No.	Age	Sex	Country	ICI	Antibody	PNS	PNS symptoms	Time to onset	Treatment for PNS	Outcome	References
1	76	M	Japan	Atezolizumab	CRMP5	Striatal encephalitis	Forgetfulnes, irritability	5 months	Methylprednisolone	Improved	[7]
2	70	M	Japan	Atezolizumab	Hu, SOX1	Sensory polyneuropathy	Tactile and pain disturbances	1 month	IVIG	Not improved	[8]
3	66	F	China	Sintilimab	Hu	Encephalitis	Focal seizures	1.5 months	Methylprednisolone	Improved	[9]
4	62	F	USA	Nivolumab	Hu	Sensory polyneuropathy	Numbness in hands and feet, tremor, loss of dexterity, gait ataxia	a few days	Methylprednisolone, IVIG	Not improved	[10]
5	71	F	Switzerland	Nivolumab + ipilimumab	Hu	Limbic encephalitis	Short-term memory deficits	4 days	Methylprednisolone, natalizumab	Improved (not completely)	[11]
6	46	M	France	Pembrolizumab	Hu	Sensory neuropathy	Painful paresthesia, gait disturbance	3 months	Methylprednisolone, IVIG	Improved (temporary)	[12]
7	71	M	France	Atezolizumab	Hu	Encephalitis	Dizziness, vomiting, diplopia, gait disturbance	2 months	IVIG	Improved (not completely)	[12]
Present case	66	M	Japan	Atezolizumab	Hu, Zic4	Limbic encephalitis	Disorientation, dysphagia, gait disturbance	2 months	Methylprednisolone, IVIG	Improved (not completely)

PNS, paraneoplastic neurological syndrome; ICI, immune checkpoint inhibitor; SCLC, small-cell lung cancer.