Mania associated with thymoma. A case report in Colombia.




Mania, Autoimmune encephalitis, Paraneoplastic syndrome, Thymoma


Antibody-mediated encephalitis may not be easily recognizable and has a heterogeneous and polymorphous presentation at the crossroads of oncology and neuropsychiatry. In this article, a case of 75-year-old female with an advanced Thymoma is presented. This patient debuts subacutely with neuropsychiatric symptoms, with positive findings in neurologic and mental exams, and laboratory results. The initial treatment worsened the affective symptoms, which required a switch to high doses of antipsychotic medication. This case allows for discussion of pathophysiological, clinical, diagnostic and treatment aspects of a patient with an unresectable neoplasia associated with neuropsychiatric symptoms. Additionally, immune treatment generates clinical difficulties. 


​​1. Dalmau J, Graus F. Antibody-Mediated Encephalitis. New England Journal of Medicine. 2018 Mar;378(9):840–51. DOI:

​2. Grativvol RS, Cavalcante WCP, Castro LHM, Nitrini R, Simabukuro MM. Updates in the Diagnosis and Treatment of Paraneoplastic Neurologic Syndromes. Vol. 20, Current Oncology Reports. Current Medicine Group LLC 1; 2018. DOI:

​3. Uy CE, Binks S, Irani SR. Autoimmune encephalitis: Clinical spectrum and management. Vol. 21, Practical Neurology. BMJ Publishing Group; 2021. p. 412–23. DOI:

​4. Dalmau J, Armangué T, Planagumà J, Radosevic M, Mannara F, Leypoldt F, et al. An update on anti-NMDA receptor encephalitis for neurologists and psychiatrists: mechanisms and models. Vol. 18, The Lancet Neurology. Lancet Publishing Group; 2019. p. 1045–57. DOI:

​5. Graus F, Titulaer MJ, Balu R, Benseler S, Bien CG, Cellucci T, et al. A clinical approach to diagnosis of autoimmune encephalitis. Vol. 15, The Lancet Neurology. Lancet Publishing Group; 2016. p. 391–404. DOI:

​6. Pollak TA, Lennox BR, Müller S, Benros ME, Prüss H, Tebartz van Elst L, et al. Autoimmune psychosis: an international consensus on an approach to the diagnosis and management of psychosis of suspected autoimmune origin. Vol. 7, The Lancet Psychiatry. Elsevier Ltd; 2020. p. 93–108. DOI:

​7. Graus F, Dalmau J. Autoimmune encephalitis or autoimmune psychosis? Vol. 50, European Neuropsychopharmacology. Elsevier B.V.; 2021. p. 112–4. DOI:

​8. Restrepo-Martínez M, Espinola-Nadurille M, López-Hernández JC, Martínez V, Téllez-Martínez JA, Bustamante-Gómez PA, et al. Neuropsychiatric aspects of anti-NMDA receptor encephalitis. Vol. 68, Revista Alergia Mexico. Nieto Editores; 2021. p. 251–63. DOI:

​9. Seery N, Butzkueven H, O’Brien TJ, Monif M. Rare antibody-mediated and seronegative autoimmune encephalitis: An update. Vol. 21, Autoimmunity Reviews. Elsevier B.V.; 2022. DOI:

​10. Lee WJ, Lee HS, Kim DY, Lee HS, Moon J, Park K il, et al. Seronegative autoimmune encephalitis: clinical characteristics and factors associated with outcomes. Brain. 2022 May 5; DOI:

​11. Martinez I, Šulentić V, Nanković S, Žarković K, Dobec-Gorenak D. Unpredictable relapses in seronegative autoimmune encephalitis. Vol. 42, Neurological Sciences. Springer-Verlag Italia s.r.l.; 2021. p. 5391–3. DOI:

​12. Abboud H, Probasco JC, Irani S, Ances B, Benavides DR, Bradshaw M, et al. Autoimmune encephalitis: Proposed best practice recommendations for diagnosis and acute management. Vol. 92, Journal of Neurology, Neurosurgery and Psychiatry. BMJ Publishing Group; 2021. p. 757–68. DOI:

​13. Toro J, Cuellar-Giraldo D, Duque A, Minota K, Patiño J, García M. Seronegative Paraneoplastic Limbic Encephalitis Associated with Thymoma [Internet]. 2017. Available from: DOI:

​ ​



How to Cite

Castro-Martínez, J. C., Ortiz Castellanos, A. F., Mojica Ospina, L. E., & De la Espriella Guerrero, R. A. (2023). Mania associated with thymoma. A case report in Colombia . Archivos De Neurociencias, 28(4).



Case report